Accounts Payable Forms	Accounts Payable Tel No (818) 677-3472 Fax No: (818) 677-4581 Mail Drop: 8202
	Sundial Commission Form (Sundial Only)

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PLEASE PROCESS A STUDENT COMMISSION PAYMENT FOR THE PERIOD FROM: TO: IN THE AMOUNT OF: $ .

The student information is as follows:

Name:  Home Address:

Student ID:   Student Email Address:

RESIDENCY STATUS: (Mandatory - Check one only)
* U. S. Citizen	* Resident Alien (Green-card holder)	** Foreign National

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Your commission payment may be picked up at University Cash Services.
Please use the following chartfield string:					REQUISITION NO:
ACCOUNT:	FUND:	DEPT ID:	PROGRAM:	CLASS:	PROJECT/GRANT:	AMOUNT:

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Name of Authorized Approver:
Signature: ______________________________________	Date: __________
Print Name:	Ext: __________

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* Commissiona are reportable income for which a FORM 1099 will be issued.

** 14% withholding will be required. Form 1042-S will be issued.

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Signature of Payee: _______________________________	Date: __________
Attachment: Vendor Data Record Form