Cash Advance Request Form Instructions
Do not use this form for individual travel , please refer to 302 Travel Advance Policy.
This Cash Advance Request Form along with the Individual/Department Custodian Agreement are used to request cash advances for non-travel cash advances, human subject studies, foreign project studies, group and team travel, international group travel, recruiting advances, and non-travel athletic meals.
Please attach this signed form to the Individual/Department Custodian Agreement before it is sent onto the Department for review and approval.
For changes to current, outstanding Non-Travel Cash Advances and Cash Advances, please fill out this form and sign. This form is required in order to request additional funds, change of end dates, and/or change of custodian information.
Cash Advances may only be given to authorized/permanent UW employees or Department. The cash advances are issued for a specific purpose and may not be used for any other purpose than expressed on the Cash Advance Request Form. All advances must be properly accounted for the use of the funds within 30 days of the end of the advance period.
All Cash Advances require , at minimum, monthly review and reconciliation to the authorized cash advance levels . Quarterly reporting of expenditures is required , at a minimum, by using the Cash Advance Accounting Form.
Fields |
Information Required |
|---|---|
Amount |
Leave blank – will auto fill based on the total for Itemized Expenditures |
Date |
Leave blank – will auto fill with current date |
Fund |
3-digit fund or appropriation Fund Listing . |
FY |
Fiscal Year – last two digits |
Acct# |
4-digit acct/project associated with this fund/UDDS coding (if applicable) |
Unit |
Leave as is. “A” is for UW Madison |
Div |
First 2-digits of the UDDS code is for the division UDDS Listing |
Dept |
Last 4-digit of the UDDS if for the department UDDS Listing |
Act |
1-digit activity code |
Class |
Leave class code as is 2190 (Custodian Cash Advance) Class/Account Code Listing |
Cash Advance No |
Enter unique 7digit Cash Advance No from original Cash Advance Request Form. All Cash Advances will start with NR , followed by the unique 7 digit Cash Advance No. (See Cash Advance procedures for more info.) |
Check applicable boxes |
Check the appropriate box which apply to the Type of Cash Advance request this is: ____ Less than 3 months ____ 3 months or greater ____ Group/Team Travel ____ Human Subject Study ____ Out of State (in US, but not in Wisconsin ) ____ Foreign Project (outside of US) ____ Petty Cash ____ Change Fund |
Time Period Start Date: End Date: |
Enter the cash advance start date and the expected end date. Note: A Cash Advance Accounting must be completed within 30 days after the end date of this Cash Advance. If moneys are owed back, then a check for the amount due must be attached to the Cash Advance Accounting form. |
Custodian Name (Check payable to) : |
|
Custodian Name |
Full name of Custodian |
Check payable to |
If payable to bank account, use last 5 digits of bank acct and the name of the bank account. If payable to other than the Custodian, enter the Department/Division Name. |
Building |
Building Name |
Address |
Street/PO address of Payee |
City, State/Zip |
Name of city, state, and zip of Payee |
To: (If different than the Custodian Address) |
|
Deliver to |
Full name of Deliver To person |
Building |
Building Name |
Address |
Street/PO address of Deliver To person |
City, State/Zip |
Name of city, state, and zip of Deliver To person |
Call: (Name and phone number of person to call) |
|
Itemized Budget |
|
Travel |
On lines provided, fill in who is traveling, what the purpose of the travel is, where they are traveling, and when they are traveling. Enter how many travelers and provide a list of participants. Estimate the cost of the following: Airfare Lodging Meals Other Under the Amount column, enter the total of the above travel amounts. Double check to make sure totals in the Amount column agrees with details in the travel budget section. |
Human Subject Study |
Describe the project and the estimated cost. Under the Amount column, enter the total expected cost of the study, which will be included in this advance. |
Petty Cash Fund (if applicable) |
Set up by departments for handling small purchases. The petty cash fund is usually less than $100. Describe the operation which is requesting a petty cash fund. Under the Amount column, enter the total petty cash amount being requested. |
Change Fund (if applicable) |
Departments involved in revenue producing activities which require coin/currency on hand for retail transactions. Describe the operation which is requesting a change fund. Under the Amount column, enter the total change fund being requested. |
Total |
Leave blank – amount should auto fill based on detail budget amounts above. |
Signature Information |
|
Date/Name of Custodian |
Current date and signature of Custodian requesting advance |
Department Approval |
Current date and signature of Department Approval. Print name of approver |
Dean/Director Approval |
Current date and signature of Dean/Director Approval. Print name of approver |
Send to |
After approvals are obtained send to: Cash Management 21 N. Park Street, Suite 6101
|
Custodian/Department: Keep a copy of this Cash Advance Request form along with the Individual/Department Custodial Agreement for your internal records.
Dean/Director's Office: Keep a copy of this Cash Advance Request form along with the Individual/Department Custodial Agreement for your internal records. Send original documents onto Cash Management, 21 N. Park Street, Suite 6101.
Cash Management Contacts:
Sharon Hughes | Barb Bausch | Cash Management
Procedure: 301-Cash Advances