Award Request Form

Congratulations on your award! Please complete the form below in order to receive your award payment.

**DISCLAIMERS**

1. Award winners should complete this form within four weeks of notice of award, otherwise the funding may be inaccessible.

2. You must provide the following information using the required fields below to secure payment funds.

3. Please be advised that you will be subject to tax liability as a result of the transaction. A percentage of international wire transfer funds may be subject to withholding.

We can only distribute funds via this process. If you have any questions about this form, please email Carrie Fang at cfang@udel.edu.

Contact Information

First Name

Last Name

Email Address

Mobile Phone

Team Name

Are you affiliated with UD?

What is your affiliation with UD?

UDID

Expected Graduation Term

Expected Graduation Year

Have you received payment from UD before? (i.e. payroll or other award payments)

Are you a UD Alumni?

UDID

Current Employer

Job Title

Award Information

Award Received

If you received more than one award, you will need to complete a form for each award.

What award did you receive?

Amount Awarded

Please enter any additional comments about your award.

Payment Information

Do you intend to use your award payment for personal usage or to fund your business/non-profit entity?

Personal usageBusiness/Non-profit Entity (the entity needs to be formally established to receive payment)

Are you a U.S. Citizen or resident alien?

International Wire-Transfer Banking Information

Individuals residing outside of the United States will be paid via a bank wire transfer. If you have any questions about this form, please email Carrie Fang at cfang@udel.edu.

Bank Wire Transfer

Payment will be provided via bank wire transfer in US dollars once required paperwork has been received.

***Both forms needs to be physically signed with a pen, scanned and uploaded below. Digital signature will NOT be accepted.***

1. Upload a completed copy of the Supplier Data Collection Form.

2. If you are receiving the award payment as an individual, upload a completed copy of the W8-BEN form. If you are receiving the award payment through a business or organization, fill out a completed copy of a W8-BEN-E form.

Please type your full name below to acknowledge both forms have been physically signed and uploaded.

Domestic Transaction

Tax form 1099s will be issued to US citizens when the sum of annual payments from the University of Delaware to the individual exceeds $600.

W-9 Reference Number: Please complete this online W-9 form in order to obtain your reference number.

Legal Name (same as submitted on your W-9)

Mailing Address (same as the address on your W-9)