Disbursements Forms

AG-202
Check Request Form
2012-September
 
Citibank Cardholder Dispute Form (Non-Travel)
AG-610
Departmental Purchase Request
2012-August
AG-106
Independent Contractor Status Certification
2021-October
AG-817
Missing Receipt Documentation
2012-September
AG-212
Outgoing Wire Transfer Request

AG-212 Instructions

2018-May
AG-616
Payment Card Cardholder Application/Approval Form
2012-September
AG-607
Payment Card Cardholder Charges/Usage
2012-September
AG-617
Payment Card Check Out/Check In Log
2012-October
AG-296
Personal Reimbursement
AG-204
Purchase Voucher
2013-May
AG-203
Purchase Voucher Cancellation Request
2012-October
AG-201PV
Purchase/Travel Voucher Correction Request Form

Insert for Corrections

2012-October
AG-614
Reconciliation of Payment Card Statement to Payment Card Receipts
2012-December
AG-517
Request for Tax Withholding on Non-Salary Compensation Items

Emolument Codes

2020-October
AG-520
Required Foreign National Information for Payments Processed via Disbursements for Non-Employees
2016-October
 
Texas Sales and Use Tax Exemption Certification

Supplemental Information:
Research - Extension - TVMDL

2020-July
 
Texas Tax Exempt Entity Verification Letter
2014-February
AG-613
Transaction Log

For Department Use Only

2012-September
AG-615
User/Supervisor Statement of Responsibility
2012-September
 
Vendor Direct Deposit Authorization
2021-May
AG-254
Voluntary Offset
2014-March
 
W-9 (Substitute Form W-9)
2017-October

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