<p> Authorization for Payment of Departmental Stipends Summer Awards (Enter Aid Year)</p><p>Please type required award information on this form and email a signed PDF copy to [email protected].</p><p>Stipend Name Item Type Number College Department</p><p>Organization Department (9.2) Fund Category (9.2) Fund (9.2) Function (9.2) Project ID (9.2) Program (9.2) Purpose (9.2) Site (9.2)</p><p>Career Credit Hour Requirements Undergraduate (UG) Graduate (GR)</p><p>Account Manager Certification Statement: I hereby certify that payment is to be made on the above-named account for a STIPEND for the named individual: for tuition, books and living expenses; that this payment or series of payments does NOT represent wages (compensation) for work performed or services rendered to the University of North Texas, and that there is no employee/employer relationship represented by the referenced stipend payment(s).</p><p>Name of Authorized Account Manager Signature and Certification of Authorized Account Manager Date Phone / / ( ) - </p><p>Name of Authorized Contact Representative(s) Signature of Authorized Contact Representative(s) Date Phone / / ( ) - / / ( ) - </p><p>Signature of Approving Research Administrator Name of Approving Research Administrator Date Phone (required to process grant awards*) / / ( ) - *Project ID accounts require Research Administrator approval.</p><p>Revised 06/2016 Authorization for Payment of Departmental Stipends Summer Awards (Enter Aid Year)</p><p>Please type required award information on this form and email a signed PDF copy to [email protected].</p><p>Stipend Name Item Type Number College Department</p><p>Organization Department (9.2) Fund Category (9.2) Fund (9.2) Function (9.2) Project ID (9.2) Program (9.2) Purpose (9.2) Site (9.2)</p><p>Comments Monthly Begin Date End Date New Revise Cancel Student Name EMPLID Total Amount (Make note of Credit Hour Amount (Month/Day/Year) (Month/Day/Year) Award Award Award Exceptions, etc.)</p><p>$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $</p><p>Revised 06/2016</p>