Print the form and complete as follows:
- Fill in effective date: This is the date the Fund-Program-Dept code is to become active or current date if immediate.
- Check one of the four reasons (in bold) for the request and any items listed below the checked item.
- Request for change in Fund-Program-Dept code name
include the Fund-Program-Dept to be changed and state the new name of the Dept
- Request for change in authorized signature
include the Fund-Program-Dept code to be changed, include all requested authorized signers.
- Request to close out a Fund-Program-Dept code
include Fund-Program-Dept to be closed include necessary forms to close out any remaining revenue, expenditure or cash balances.
- Request for a new Fund-Program-Dept code
complete all fields as indicated below:
- Select Department or Project:
If you are requesting a new department code (long term activity) place an X in front of department, if you are requesting a new project code (short term activity) place an X in front of project.
- Describe proposed use of the Dept and the reason it is necessary:
The need for the new Fund-Program-Dept must either be a new program, a new grant, or of a significant dollar or transaction amounts that separate recording and reporting is necessary. All requests will be reviewed based on the information supplied with the request form to determine if a new Dept is needed or if the activity can be combined with an established Fund-Program-Dept.
- Source of Funding:
This determines the Fund assigned to the Dept. Is it GPR funds, a Federal grant or non-federal grant, a gift, or program revenue? Be specific as to the source of the funds. Include a complete statement of how revenue will be generated and how rates were determined.
- Fund-Program-Dept Name:
Use a name that is an indication of its use so it is easily recognized.
- Include all authorized signers:
Include all names that can sign for expenditures.
- Project period of Fund-Program-Dept:
If Dept is to be kept open for a certain period of time, include those dates. If there is no set time period, leave this field blank.
- Manager name:
Person responsible for monitoring Dept for proper activity . Also include the appropriate department.
- If this is a fund 128 Dept, include the Auxiliary report number
the code is to be added to. (If unsure, contact Jodi Sumpter @ 5785).
Fund 128 interest earnings. (If unsure, contact Jodi Sumpter.)
- Signature of Requester: Person requesting the new Fund-Program-Dept
- Signature of Division Budget contact: Robert Kirk, Interim Budget Director
Once the form is signed by the Division Budget Contact, make a copy to keep and submit the original to Financial Services, Hyer Hall 110. A copy will be returned when all activity has been completed by Financial Services.