Forms for Disbursements

Find forms below for direct deposit; human subjects; payment request; petty cash; Scrip; signature authorization; and checks, drafts, and wires.

Please read the full Personal Notification Statement before completing the forms listed below. It explains why the information requested must be provided. Unfortunately, if the material you provide isn't correct or complete, the requested action may not be processed.

About the forms:

All forms have been created with Microsoft Office 97 Excel (version 7.0). Just click the form name to open it. Forms listed on the left open in Excel; forms on the right open in Adobe Acrobat, which requires installation of Acrobat Reader on your workstation. After the form is open, choose one of the following options:

  • Print the form, then complete and submit it to Disbursements.
  • Click File, then Save As at the top of your Internet browser window and select the location where you'll store the file.

Excel forms are editable, but Adobe Acrobat forms that are opened using Acrobat Reader are not. If you need assistance with any of the forms, contact Ellen Sanders, (858) 534-0993.

M/S Excel
Adobe Acrobat (PDF)
Direct Deposit Forms
Non-UC employees   Non-UC employees
UC Employees   UC Employees
Vendors   Vendors
Human Subjects
Certification of Cash Payment or Gift Cert. to Human subjects   Certification of Cash Payment or Gift Cert. to Human Subjects
Payment Request Forms (non Payroll)
Payment Adjustment Request   Payment Adjustment Request
Payment Request   Payment Request
Petty Cash
Request for Petty Cash Reimbursement   Request for Petty Cash Reimbursement
Petty Cash Fund Reimbursement Schedule   Petty Cash Fund Reimbursement Schedule
Scrip Program
Certificate of Payment   Certificate of Payment
Scrip Issue Log   Scrip Issue Log
Scrip Order Form   Scrip Order Form
Signature Authorization
Signature Authorization or Cancellation   Signature Authorization or Cancellation
Checks, Drafts, and Wires
Affidavit of Forged Endorsement   Affidavit of Forged Endorsement
Wire Transfer Request   N/A
Draft in Foreign Currency   N/A
Fax Transmittal
Fax Transmittal for Subrecipient Invoices   N/A

Departments


Disbursements