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California State University, Long BeachCalifornia State University, Long Beach

Administrative Payment Request

GENERAL INSTRUCTIONS:

  1. Review the Detailed Instructions for Admin Payment Form
  2. Complete the form and use the button below to display a printer friendly version.
  3. Print the "Printer Friendly Version" of the form.
  4. Return the completed form, and supporting documentation to:
For LBCMP University Controller Accounts Payable Department Foundation Building (FND 280) 6300 State University Drive Long Beach, CA 90815-4680 USA

For LBFDN CSULB Research Foundation Accounts Payable Foundation Building (FND 332) 6300 State University Drive Long Beach, CA 90815-4680 USA

Fields with * are required.

BUSINESS UNIT

*Select Business Unit that will be making payment.
PAYMENT TYPE

*Select payment type.

Note: If wire transfer is requested by payee, please attach the wire transfer instructions to the completed form.
Vendor Information

Indicate Peoplesoft Payee/Vendor Number. If new, 204 must be attached or indicate if not applicable.

Note: A vendor 204 form must be on file with the Accounts Payable department for all vendors unless:
  1. The payee is a CSULB Student
  2. The Payee is a CSULB employee
  3. The payee is being refunded monies previously collected by the campus
Examples of a refund:
  1. Return of a deposit
  2. Payment for returned show tickets originally paid by check or cash
  3. Cancelled citation.
Vendor 204's are not required for refunds or returns of deposits.
Please note a vendor 204 form is a substitute W9.

PAYMENT AMOUNT AND DATE NEEDED

$
PAYABLE TO

Enter full name, mailing address, and contact information for the payee.

PURPOSE
*Enter the justification or purpose of the expenditure.
CHARTFIELD INFORMATION
  1. Indicate the chartfields to be charged. Amounts should total the amount of the payment being made to the vendor
  2. Please note that the chartfield grid on this form does not support Inter Business Unit Billing
  3. If the chartfields required exceed the lines provided on the form a separate sheet may be submitted.

*Amount *Account *Fund Dept ID Program Class Project
$
$
$
$
$

STATEMENT OF REQUESTOR AND APPROPRIATE ADMINISTRATOR'S RESPONSIBILITY

I certify this payment is consistent with business practices for the University and is required for operations.

Requestor's Signature
Appropriate Administrator Signature
PICK-UP

Special Request Disposition


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DETAILED INSTRUCTIONS

Administrative Payments Definition

Administrative payments are defined as payments made on behalf of the University and are required for operations. These payments are not for goods or services and typically will not be supported by an invoice from a vendor. Documentation in support of the payment may be an account/project reconciliation, or request letter. In many instances these payments may be characterized as flow through transactions or administrative adjustments in which the University has collected monies and is in turn making the appropriate disbursement to an individual, corporation, auxiliary, or government agency.

Some examples of administrative payments would include:

  • Governmental payments
    • State Board of Equalization
    • Franchise Tax Board
    • Internal Revenue Service
  • Facilitating the Claims process with the State Controller’s Office
  • University Credit Card or Postage Consolidations:
    • Procurement Card
    • Business Travel Accounts
    • Postage Bank Replacements
    • Refunds for deposits
    • Payments of a Business Unit's consolidated billing for bank cards such as Procurement/One Card or Business Travel Accounts

To request an administrative payment for LBCMP, submit a completed, signed and approved, “Request for Administrative Payment”form along with supporting documents to the Controller’s Office- Accounts Payable, FND suite 280 – MS 9901. If you need assistance please contact the Controller’s Office Accounts Payable, Ext 5-2512, for LBFDN, submit to CSULB Research Foundation, Accounts Payable, FND suite 322 – MS FND BLDG

  1. Indicate method of payment desired, check wire transfer or ACH/EFT - If wire transfer, wire instructions as provided by the payee must be provided to Accounts Payable.
  2. Today’s Date/Need by Date - Complete date sections (Please allow 7 business days for processing once received in Accounts Payable).
  3. Amount of payment - All payments will be in US dollars unless otherwise indicated.
  4. Vendor # - Please indicate the People Soft/Oracle Vendor number. If this payee is new to Oracle, a vendor 204 form may be required. For refunds of amounts collected from the public, no 204 is required. If you need assistance, please contact the Accounts Payable department.
  5. Payee Information - Name, Address, City, State and Zip
  6. Chartfields – Indicate the PeopleSoft chartfields to which the disbursement is to be charged.
  7. Purpose or Reason for Payment - Provide a brief explanation of the need for the payment. Examples: quarterly sales tax payment, transfer to auxiliary for monies held at the state, refund of deposit, payment of management fees
  8. Check Pick-up Information - All checks will be dispatched via U.S. mail unless otherwise indicated in this section. The reason or justification for pick-up must be noted. Examples: Must include tax forms, must send certified mail, must deposit at cashiers.
  9. Name & Signature – Enter the names and signatures of employee requesting the payment and the appropriate approving administrator. Each payment does require two Signatures.
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