Reimbursement

Are you being reimbursed by purdue? Yes

What department is reimbursing you? CERIAS

Are you domestic or international? International

What type of address do you have? Foreign address (excluding Mexico and Canada)

What type of bank account do you have? US Bank Account (including Mexico and Canada)

What type of visa are you on? Other

Please print and complete all of the forms listed below. Make sure you sign and date all of the forms. Mail all completed forms, original receipts, and copies of documents to:

Forms

• Substitute W9 Form
  DocuSign Payee Certification

Copies Needed