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REQUEST FOR MISCELLANEOUS PAYMENT WITHOUT AN INVOICE T-27 FORM Important: Do not use this form if: A vendor record hasn’t been created in IRIS. A vendor must be requested and created before submitting this form. Vendor Name: IRIS Vendor #: Address: SSN/ITIN/FIN#: Contract # (If applicable): UT Departmental Name: Amount Requested: UT Departmental Email: Amount Requested Hour/Day/Week/Lump Sum X Rate = Amount to Pay: Dates of Service: __________________to __________________________ Description of services or goods being provided: Fund G/L IO Amount Approval - For Non-Resident Aliens only, the original form must be forwarded to the Treasurer’s Office. - If payment is to an individual, do the services listed on the worker’s classification questionnaire attached to their vendor record in IRIS agree with those listed on this form? This does not apply if the vendor is a company or other entity. Yes No If “No”, an updated worker classification questionnaire needs to be completed and attached to this form. Is the payment to a university employee? Yes No Only royalty and clinical trial payments may be processed to employees. All other payments must be made through payroll or an exception granted by the Treasurer’s Office. Is the payment to a current or future UT student? Yes No If yes, a written correspondence must be obtained from the campus financial aid office and attached to the request. In what Country were these services performed? Were the services performed by a non-resident alien? Yes No If yes, the University’s Independent Contractor/Guest Traveler form and all applicable documents must be attached to this request. Visit the System Payroll Office website to learn more about the forms required for these payments – http://payroll.tennessee.edu/ Date:__________________________

Request for Special Payment - University of …payroll.tennessee.edu/pdfs/t-27.pdfREQUEST FOR MISCELLANEOUS PAYMENT WITHOUT AN INVOICE ... Visit the System Payroll Office website to

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REQUESTFORMISCELLANEOUSPAYMENTWITHOUTANINVOICE

T-27FORMImportant:Donotusethisformif:

• Avendorrecordhasn’tbeencreatedinIRIS.Avendormustberequestedandcreatedbeforesubmittingthisform.

VendorName: IRISVendor#: Address: SSN/ITIN/FIN#:

Contract#(Ifapplicable):

UTDepartmentalName:

AmountRequested:

UTDepartmentalEmail:

AmountRequestedHour/Day/Week/LumpSum XRate =AmounttoPay: DatesofService:__________________to __________________________Descriptionofservicesorgoodsbeingprovided:

Fund G/L IO Amount Approval

-ForNon-ResidentAliensonly,theoriginalformmustbeforwardedtotheTreasurer’sOffice.-

• Ifpaymentistoanindividual,dotheserviceslistedontheworker’sclassificationquestionnaireattachedtotheirvendorrecordinIRISagreewiththoselistedonthisform?Thisdoesnotapplyifthevendorisacompanyorotherentity.

YesNo

If“No”,anupdatedworkerclassificationquestionnaireneedstobecompletedandattachedtothisform.

• Isthepaymenttoauniversityemployee?

YesNo

Onlyroyaltyandclinicaltrialpaymentsmaybeprocessedtoemployees.AllotherpaymentsmustbemadethroughpayrolloranexceptiongrantedbytheTreasurer’sOffice.

• IsthepaymenttoacurrentorfutureUTstudent?YesNo

Ifyes,awrittencorrespondencemustbeobtainedfromthecampusfinancialaidofficeandattachedtotherequest.

• InwhatCountryweretheseservicesperformed?

• Weretheservicesperformedbyanon-residentalien?

YesNo

Ifyes,theUniversity’sIndependentContractor/GuestTravelerformandallapplicabledocumentsmustbeattachedtothisrequest.VisittheSystemPayrollOfficewebsitetolearnmoreabouttheformsrequiredforthesepayments–http://payroll.tennessee.edu/

Date:__________________________