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Accounts Payable

Accounts Payable Check Request

This form is used for the purchases of services. For further clarification on how to use this form, please review the AP Check Request online video tutorial.    (Last Modified: 02/29/12)

AP Invoice Copy Request

This form is used when you are requesting a copy of an accounts payable invoice.    (Last Modified: 05/17/04)
Available Format(s):  DOC * | PDF *

Department Accounts Payable Representative Request Form

This form may be used to Add the Accounts Payable Representative for your department.    (Last Modified: 12/17/10)
Available Format(s):  Webpage *
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


Corporate Card

Individual Corporate Cardholder Application

This form should be used for a individual requesting a Corporate Card.    (Last Modified: 10/30/12)
Available Format(s):  DOC * | PDF *

Corporate Card Missing Receipt

This form should be used to document Corporate Expenses when the original receipt has been lost. The use of this form is expected to be on an exception basis and not a common occurrence.    (Last Modified: 12/29/05)
Available Format(s):  DOC * | PDF *
For more information, please see...

Corporate Card Reinstatement Request

This form should be used to reinstate a card after suspension.    (Last Modified: 08/22/07)
Available Format(s):  PDF * | DOC *

Department Corporate Card/WORKS Setup Form

This form should be submitted with new card applications    (Last Modified: 01/17/14)
Available Format(s):  XLS * | PDF *

Statement of Corporate Card Disputed Items

This form should be used to dispute an unauthorized or unrecognized charge appearing on your Corporate Card account. Transactions that are more than 60 days old are not eligible for dispute.    (Last Modified: 06/12/09)
Available Format(s):  PDF *
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


Tax

IRS Tax Exemption Letters - 501(c)(3)

IRS Tax Exemption Letters - 501(c)(3) for Duke University and Duke University Health System, Inc.
Available Format(s):  Webpage

W-9 for Associated Health Services, Inc.

(a.k.a. Davis Ambulatory Surgical Center)
IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 10/02/12)
Available Format(s):  PDF

W-9 for Duke University

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke University Health System, Inc.

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke University Hospital

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 10/02/12)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Regional Hospital (formerly Durham Regional Hospital)

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 06/22/13)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Raleigh Hospital

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke University Affiliated Physicians (DUAP)

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Hospice

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Home Health

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Home Infusion

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...

W-9 for Duke Integrative Medicine

IRS Form W-9, Request For Taxpayer Identification and Certification is used by payers to properly report tax information from miscellaneous payments made to either, Duke University (for grants, contracts, interest, etc.) or Duke University Health System (for medical services, interest, etc.). Donors may also request a Taxpayer Identification Number to enable them to claim tax deductions for gifts or donations.    (Last Modified: 02/14/08)
Available Format(s):  PDF *
For more information, please see...
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


Foreign Entities

Duke University Certificate of Foreign Status

This form is used for non-resident alien payments of other than substantiated expenses. Completed form must be attached to an Accounts Payable Check Request when requesting payment or it must be attached to a Purchase Requisition when you are requesting a Purchase Order.    (Last Modified: 12/01/10)
Available Format(s):  XLS * | PDF *
For more information, please see...

Foreign Vendor Questionnaire

This form is used to determine whether payments made to a Non-US Taxpayer require tax reporting or withholding. The completed form and any applicable IRS documents should be submitted with the associated Accounts Payable Check Request or Purchase Requisition when requesting a purchase order.    (Last Modified: 08/15/11)
Available Format(s):  PDF *

Department Certification for Foreign Vendor Questionnaire

This form can be used by the department as a substitute for the Foreign Vendor Questionnaire. It should be completed by an individual in a department that has direct knowledge of the Non-US Taxpayer's status and the full nature of the engagement. The completed form and any applicable IRS documents should be submitted with the associated Accounts Payable Check Request or Purchase Requisition when requesting a purchase order.    (Last Modified: 08/15/11)
Available Format(s):  PDF *

8233, Exemption From Withholding on Compensation
for Personal Services of a Nonresident Alien Individual

Use this form if you are a nonresident alien individual who is receiving compensation for independent personal services performed in the United States, compensation for dependent personal services performed in the United States, or Noncompensatory scholarship or fellowship income and personal services income from the same withholding agent.    (Last Modified: 12/01)
Available Format(s):  PDF ~
Instructions: PDF
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


Purchasing Programs

Funeral Floral Request Request Form

In the event of the death of an employee or member of the employee's immediate family, the department designee should complete a Funeral Request Form and call an approved florist.    (Last Modified: 07/22/09)
Available Format(s):  DOC | PDF
For more information, please see...

Sympathy Floral Request Request Form

In the event the visitation was missed or if there is no service, a sympathy plant can be delivered to the employee's local home address or the employee's Duke address. Complete a Floral Request Form and call an approved florist to have flowers sent in the name of Duke University and Health System and the department.    (Last Modified: 07/22/09)
Available Format(s):  DOC | PDF
For more information, please see...

Hospital Stay Floral Request Request Form

In the event an employee is hospitalized, the department designee should complete a Hospital Request Form and call an approved florist.    (Last Modified: 07/22/09)
Available Format(s):  DOC | PDF
For more information, please see...

Staples Order Form

Fax Version of Staples/Corporate Express order form.    (Last Modified: 07/22/09)
Available Format(s):  XLS | PDF

Eway Online Ordering Registration Form

To use Eway - the online ordering system for Staples already widely used for office supplies, you must register with Staples. You will need a separate Eway account to order forms even if you are already using Eway to order office supplies.    (Last Modified: 07/22/09)
Available Format(s):  Webpage ~ | DOC ~

National Car Rental Emerald Club Application Request

To enroll as an Emerald Club member, please call the 888 Toll-Free number on the application to immediately enroll. You will need to have the application, your drivers license and credit card numbers in order to enroll. Once your phone call is complete, sign and fax the application with your signature to 612-893-6041 and your Emerald Club Number will be active within 48 hours. Use the temporary card at the bottom of the application until your permanent card comes in the mail in 4-6 weeks.    (Last Modified: 07/22/09)
Available Format(s):  DOC | PDF

National Welders Order Form for Duke

To place an order save the Duke Order Form to you PC, fill it out, and email it to National Welders.    (Last Modified: 06/17/13)
Available Format(s):  XLS | PDF

Research Storeroom Requisition

Can be used to place in window order for the Research Storeroom    (Last Modified: 08/02/10)
Available Format(s):  DOC | PDF
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


For Vendors

Research Support Services Agreement (RSSA) Form & Instructions

The Duke University Research Support Services Agreement (RSSA) should be utilized to procure outside services on sponsored codes (20X, 30X-35X, 38X, 293 & 393). This agreement should be utilized only when a determination is made that the entity is a vendor under the definition in OMB Circular A-133.    (Last Modified: 09/26/14)

RSSA Rider A: Scope of Services, Deliverables & Payment Schedule

To be accompanied by Research Support Services Agreement (RSSA). This Rider is required for all RSSAs.    (Last Modified: 09/26/14)
Available Format(s):  PDF
Instructions: PDF
For more information, please see...

RSSA Rider B: Foreign Contract Additional Terms and Conditions

To be accompanied by Research Support Services Agreement (RSSA) if necessary. Use only if the entity is foreign.    (Last Modified: 09/26/14)
Available Format(s):  PDF
Instructions: PDF
For more information, please see...

Independent Contractor Checklist (ICC)

This form is used to determine if an individual performing services for the University qualifies (per the IRS) as an Independent Contractor or must be paid as a Duke employee. Completed form must be attached to an Accounts Payable Check Request when requesting payment for individual services, or it must be attached to a Purchase Requisition when you are requesting a Purchase Order.    (Last Modified: 05/21/13)
Available Format(s):  XLS * | PDF *
For more information, please see...

Outside Services Agreement (OSA)

An OSA must be completed when engaging individuals or companies to perform certain outside services. It is a contract between Duke and the contractor.    (Last Modified: 05/08/2014)
Available Format(s):  DOC | PDF
For more information, please see...

Outside Services Agreement Insurance Exception Request Form

While it is not standard practice to waive the institutional insurance requirements, Corporate Risk Management may do so when circumstances dictate. To submit a request to waive one or more of these coverage's, please complete and submit the Insurance Exception form along with the required documentation.    (Last Modified: 05/18/10)
Available Format(s):  DOC * | PDF *

Foreign Vendor Questionnaire

This form is used to determine whether payments made to a Non-US Taxpayer require tax reporting or withholding. The completed form and any applicable IRS documents should be submitted with the associated Accounts Payable Check Request or Purchase Requisition when requesting a purchase order.    (Last Modified: 08/15/11)
Available Format(s):  PDF *

Department Certification for Foreign Vendor Questionnaire

This form can be used by the department as a substitute for the Foreign Vendor Questionnaire. It should be completed by an individual in a department that has direct knowledge of the Non-US Taxpayer's status and the full nature of the engagement. The completed form and any applicable IRS documents should be submitted with the associated Accounts Payable Check Request or Purchase Requisition when requesting a purchase order.    (Last Modified: 08/15/11)
Available Format(s):  PDF *

Vendor Registration Forms Package

Package including Letter from Accounts Payable, Statement of Compliance, W-9, Vendor Information Form    (Last Modified: 08/02/10)
Available Format(s):  PDF

Contractor Badge Request

This form is used to receive a valid Vendor Duke ID Badge.    (Last Modified: 08/02/10)
Available Format(s):  PDF

Statement of Compliance

Available Format(s):  DOC | PDF
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.


Additional Forms

Interdepartmental Request & Invoice Form (IRI)

The IRI form is used to order supplies or services from another department. The form is used both as a request form and as a priced invoice. Some service areas have their own form so that they can get additional information needed (for example, Duke Publications Group). The IRI you download will have a space for the number. You should assign a number for tracking purposes. IRI transactions show on financial reports with a "JV" reference. The number will be referenced in the description field.    (Last Modified: 05/06/04)
Available Format(s):  XLS * | PDF *
Instructions: PDF

Laboratory Equipment Statement of Hazard Assessment

The Biological Safety Division addresses employee safety, training, policies, and other concerns regarding occupational exposure to biological agents. This is accomplished through the development and implementation of policies and procedures that are intended to provide guidance for worker safety when handling biological agents. These policies are based on the applicable regulatory requirements or current safety guidelines. Laboratory equipment that needs an evaluation includes, but is not limited to the following: refrigerators, freezers, centrifuges, incubators, chemical fume hoods, biological safety cabinets and other items potentially contaminated with hazardous materials. All laboratory equipment must be free of hazardous materials (e.g. biological, chemical, radiological) prior to equipment maintenance, transport to Duke Surplus or other destinations.    (Last Modified: 05/03/12)
Available Format(s):  PDF

PERT Product & Equipment Request

Fill out form on line and email to productrequest@duke.edu. Once the completed product request has been received, you will receive automatic notices as your request progresses through the PERT process. All product requests for trial or purchase must be approved by Duke Medicine's Product and Equipment Review Team (PERT) prior to bringing the product into the hospital.    (Last Modified: 07/22/09)
Available Format(s):  PDF

Equipment Screening Certification Form ($5k-$19,999)

An equipment screening form is required when purchasing capital equipment on governmental grants and contracts (Project series 3xx - 35x). It is required by the federal government to ensure they are not funding equipment which is already available for use at the University. Use this form for purchases at least $5000, but not more than $19,999. The screening form should be sent along with the Purchase Requisition to Sponsored Programs. Sponsored Programs will approve and send to Purchasing.

This form should also be submitted when submitting items to surplus valued up to $20,000.    (Last Modified: 08/02/10)
Available Format(s):  DOC | PDF
For more information, please see...

Equipment Screening Certification Form (Over $20,000)

An equipment screening form is required when purchasing capital equipment on governmental grants and contracts (Project series 3xx - 35x). It is required by the federal government to ensure they are not funding equipment which is already available for use at the University. Use this form if equipment is $20,000 and over.

This form should also be used when submitting items to surplus valued over $20,000.

If purchasing, the screening form should be sent along with the Purchase Requisition to Sponsored Programs. Sponsored Programs will approve and send to Purchasing.
If surplusing, form should be sent as form indicates.    (Last Modified: 02/20/14)
Available Format(s):  DOC | PDF
* : Requires valid, pre-specified IP address, affiliation or NET ID.
~ : Located outside of the Financial Services domain.