FORM-5 Payment Request
The Form-5 available at the URL on this page replaces the traditional multi-part printed form.

Any campus adaptation of the form to database or spreadsheet software should keep the form's design and layout in tact so it has the same proportions on the page as the official form.

The Form-5 features expanded checklists and instructions to guide departments and Accounting in complying with relevant policies and laws. Please understand that Form-5 Payment Requests are subject to additional scrutiny and disclosure because of their sometime sensitive nature and because they often are processed without the benefit of purchasing authorization.

QUESTIONS
Please contact the following:
Bernice Yost, extension 4288, email: bernice.yost@accounting.ucsb.edu
Dolores Ramirez, extension 3929, email: dolores.ramirez@accounting.ucsb.edu
Asger Pedersen at extension 3919, or by email at: asger.pedersen@accounting.ucsb.edu.

TRAINING
Training materials are elsewhere on this web site. Classes are announced on the A/P listserv.

POLICIES
The purpose of the form "Form-5" payment request form is to substantiate a disbursement transaction for which no valid substantiation is otherwise available. Therefore, "Form-5" payment requests can be subject to any or all policies that govern procurement and disbursement. The URL "Payment Processing at UCSB--Overview" has extensive references to policies that may govern "Form-5" processing.

INFORMATION
Payment Request Instructions  PDF
Instructions for Using Adobe Acrobat to Complete the Forms (rev. 3/8/00)

FORMS -  May be filled in on the computer using Adobe Acrobat Reader 4.0 or later version.  Forms can still be printed out as before using Adobe Acrobat 3.0.
Payment Request - MISC (FORM U5- 8)  PDF
Multiple Coding Block  PDF
Privacy Notification  PDF