Reimbursement

Are you being reimbursed by purdue? Yes

What department is reimbursing you? Chemistry

Are you domestic or international? International

What type of address do you have? Domestic address (including Mexico and Canada)

How would you like to receive your reimbursement? Direct Deposit

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