Emergency Transaction Request Form Instructions

  1. Provide the name, e-mail address and phone number of the contact person who can provide more information if needed.
  2. Indicate the type of Emergency Transaction (ET) being submitted and Name of Payee (include payee contact information if payee will be picking up output):
    • Custodian Funds
    • Direct Payment (DP)
    • Payment to Individual (PIR)
    • Invoice
    • Purchase Order (include requisition number)
  3. Select one of the following methods of payment:
    • Check (if vendor is set up for ACH, payment will be sent via ACH)
    • Purchase Order
    • Check and Purchase Order
  4. Choose method for output distribution:
    • Mail check and/or PO – include date to mail by
    • email PO - include date to email by and email address
    • Fax PO – include date to fax by and fax number
    • Hold for next day pick up: choose Check Custodian or Payee
      • Check Custodian option requires a completed Check Custody Agreement to be submitted with the ET Form. See Policy 106 - Check Distribution.
      • A valid photo ID must be presented to personnel at 21 N. Park Street, Suite 5301 to ensure the appropriate documents are released.
  5. Provide a detailed explanation for requesting ET.
  6. Signature from Dean or Director should be from someone on the “Authorized to Sign Financial Documents List” for the Department.

Do not use this form for special handling payments such as:

Emergency Transactions must be hand-delivered to 21 N. Park Street, Suite 5301, before 9:00 AM to be processed for check pick up by the next business day. The ET must be presented to personnel to have the ET time and date stamped. If received after 9:00 AM, the ET will be processed for check pick up two business days later.

ET check pick up is between 8:00 AM and 4:30 PM at 21 N. Park Street, Suite 5301. A valid photo ID is required for pick up.

Emergency Transaction Request Form

Contact:

Roseanne Hatfield