Accounting Use Only
Check Request Form
The CHECK REQUEST FORM is intended for Employee Reimbursements, Research Participant Stipends, Honoraria, and
other payments where a supplier’s invoice does not exist. The total dollar amount cannot exceed $1,000. A PURCHASE
REQUISITION cannot be used to pay an employee. Direct payment of supplier invoices requires an approved PeopleSoft
PURCHASE REQUISITION to obtain a Purchase Order number. This should be done in advance of the purchase.
In the event a payment is needed for an amount greater than $1,000, where obtaining a Purchase Order in advance is not
practicable the Check Request requires the additional authorized signature of the SVP/CFO, CEO or EVP/COO. For
complete instructions, refer to policy PM-20 in the BIDMC policy manual.
Advances related to TRAVEL, TRAINING AND EDUCATION: Submit a CHECK REQUEST FORM in conjunction with
a completed TRAVEL, TRAINING and EDUCATION FORM. Cash Advances should not exceed 75% of the estimated
pre-approved TRAVEL, TRAINING AND EDUCATION dollar amount and cannot be requested more than 30 days prior
to travel. Requests for reimbursement of pre-travel purchases such as airfare, conference registrations, and hotel
accommodations use the same forms as for a cash advance. Original paid receipts are required for pre-travel purchase
reimbursement. For post-travel reimbursement complete a TRAVEL, TRAINING and EDUCATION FORM only.
Only reimbursement supported by receipts and the purchase of finished products are clearly excluded from income
reporting via IRS FORM 1099 MISC. IRS reporting requires that an IRS FORM W-9 or accepted substitute, signed by the
payee, be on file prior to payment. Please include a completed form W-9 or substitute with the CHECK REQUEST
FORM when a payment may qualify for 1099 reporting and the payee has not submitted a W-9 within the last 12 months.
PB 1189 7/06