The following forms are available to download in Word, Excel or PDF formats.
Unless specified the forms will be downloaded to the web browser's default directory.
Contact your local desktop support provider for assistance with obtaining and installing
the Acrobat Reader
for opening PDF forms and documents.
* Forms marked with an asterisk (*) are available to fill out on-line. Once filled out
please print out the form and sign, if necessary, before forwarding them to the appropriate office. All other
forms downloaded may be filled in neatly by hand or type.
| Individual Disbursement Services |
| Form Name |
Format |
Comments |
| Travel and Entertainment Expense Report (C-1) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Excel 97-2003* |
| Travel and Entertainment - Entertainment & Business Meal Worksheet(C-1A Form) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Excel 97-2003* |
| Reimbursement Justification Form (C-5 Form)
|
PDF
|
Revised 4/09 (revised form required 5/1/09) |
| Word Doc |
| Travel and Entertainment Advance Request (C-7 Form) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Word 97-2003* |
| Advance Justification Form (C-7A Form) |
PDF |
Revised 4/09 (revised form required 5/1/09)
Must accompany each Advance Request (C7) form |
Request for Payment C-368
(Payment/Reimbursements other than Travel) |
PDF* |
New form effective 11/1/2008 |
| Excel 97-2003* |
| Statement of Business Connection |
PDF |
|
| FNIF |
PDF |
Foreign National Information Form |
| Form SS-5 |
PDF |
Application for a Social Security Card |
| Form W-7 |
PDF |
Application for IRS Individual Taxpayer Identification Number |
| Form W-8 |
PDF |
Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding |
| Form W-9 |
PDF |
Request for Taxpayer Identification Number and Certification |
| Honoraria Eligibility Certification Form |
PDF |
Foreign Visitors Honoraria Eligibility Certification Form |
| C-12 Independent Contractor Determination & Certification |
PDF |
|
| CFSI |
PDF |
Certification of Foreign Source Income |
| Payroll |
| Form Name |
Format |
Comments |
| 2013 W-4 |
PDF |
Employee's Withholding Allowance Certificate |
| Tax Exemption Form |
PDF |
Application for Phila City Wage/PA State Taxpayer Exemption |
| Form I-9 |
PDF |
INS Employment Eligibility Verification |
| Graduate Student and Post Doctoral Appointment Information Form |
PDF |
You may also find the
Definitions of FULL-TIME Graduate Student Appointment page helpful. |
| Word 95 |
| Word 97-2003 |
| PA Local Earned Income Tax Residency Certification Form |
PDF* |
|
| Stop Payment Request Form |
PDF* |
|
| Word 97-2003* |
| Payroll Stale Dated Check Form |
PDF |
|
| Word 97-2003 |
| Off Cycle Payment Request |
PDF |
|
| Word 97-2003 |
| Restricted Salary Reallocation Request |
PDF* |
|
| Excel 97-2003* |
| Wage & Tax Statement Information |
PDF |
W2 Address Change |
| Word 97-2003 |
| Request for Administrative Mainframe LOGON ID (includes PennWorks) |
PDF* |
Access to Payroll, PennWorks, SAM, SFSEASI, SRS, TSO, Focus, Natural |
| MS Word* |
| PennERS Access Request Form |
PDF* |
|
| Word 97-2003* |
| Employee Information Form |
PDF* |
|
| Word 97-2003* |
| Voluntary Self-Identification Form |
PDF |
|
| Temporary/Hourly Time Reporting Form |
Excel 97-2003 |
|
| PDF |
| Request for Overpayment Calculation |
Word 97-2003* |
|
| Required forms for Foreign National Students/Scholars |
Webpage |
Listing of Forms that are required for Nonresident Aliens |
| FNIF |
PDF |
Foreign National Information Form |
| FNIS |
Webpage |
Link to Foreign National Information System |
| City Wage Tax |
| 2012 City of Philadelphia Wage Tax Refund Petition Form |
PDF |
|
| 2012 Instructions for Statement |
PDF |
|
| State W-4 Forms |
| Form DE4 (California) |
PDF |
CA Withholding Allowance Certificate |
| Form MW507 (Maryland) |
PDF |
Employee’s Maryland Withholding Exemption Certificate |
| Form MO W-4 (Missouri) |
PDF |
Employee Withholding Allowance Certificate |
| Form W-4 (New Jersey) |
PDF |
Employee's Withholding Allowance Certificate for State of New Jersey |
| Form VA-4 (Virginia) |
PDF |
Personal Exemption Worksheet |
| Form D-4 (Washington, DC) |
PDF |
Employee Withholding Allowance Certificate |
| Form D-4A (Washington, DC Non Resident) |
PDF |
Certificate of Nonresidence in the District of Columbia |
| Property Management |
| Form Name |
Format |
Comments |
| Equipment Change Form |
PDF |
To be completed when transferring ownership of equipment between schools/centers. |
| Word 97-2003 |
|
Authorization for Retirement of Equipment |
PDF |
To be completed for property items
that will be disposed of. |
| Word 97-2003 |
| Home and Remote Location Form |
PDF |
To be completed for University-Owned
Property items that will be used at home. |
| Word 97-2003 |
| Equipment Information Form |
PDF* |
To be completed by the school/center when assets are created in BEN Assets by PMG based Journal Entries and Cash Deposits or for setting up new Equipment in Process Assets. |
| Word 97-2003* |
| Donated Collectibles Form |
PDF |
To be completed by school/center when Gifts are processed through “Atlas Gift System”. |
| Word 97-2003 |
