UNIVERSITY GUEST PRESENTER RECORDING AGREEMENT EXHIBIT

Form Instructions

1. Select the date the form is actually being completed from the drop-down calendar.
2. Enter the name of a University contact person
3. Enter the name of the University area sponsoring the guest presenter, lecturer, and/or speaker.
4. Enter the name of the guest presenter, lecturer, and/or speaker.
5. Enter the name of the presentation
6. Select the date the presentation was recording using the drop-down calendar
7. Enter the amount the University agrees to pay to guest presenter, lecturer, and/or speaker.
8. Enter the dollar amount and description of any additional costs and expenses (if any) to be reimbursed by University. Provide a description and/or explanation of the additional costs. If no additional expenses are anticipated, please indicate none or non-applicable (N/A) in the space provided.
9. Enter the name of the Guest as it is to appear on the check for payment.
10. Enter the SIMBA Supplier # of the Guest
11. If Guest is being paid directly, then residency status must be declared by Guest by checking the appropriate box for tax purposes. Select one of three options as to the Guest status:
1. Guest is a United States Citizen
2. Guest is a Permanent Resident. A Non-Employee Information Form and W9 form must be completed and included with the submission of this form.
3. Guest is neither a United States Citizen nor a Permanent Resident. A Non-Employee Information form, as well as all required documentation to authorize payment. The completed Non-Employee Information form and required documentation must be included with submission of this form.
12. Enter the name of the guest as it appears in the signature line
13. Enter the complete mailing address of the Guest
14. The Guest must sign the completed form.
15. Enter the date the Guest signs the form
16. Enter the name of the University Official signing the form
17. Enter the title of the University Official signing the form
18. The appropriate University Official must sign the completed form
19. Enter the date the University Official signs the form
20. An official of Central Procurement must sign the form
21. Enter the date the form is signed by the Central Procurement official
22. If appropriate, an Assistant Treasurer signs the form
23. Enter the date the Assistant Treasurer signs the form (if appropriate)

Print the completed form and have the Guest sign and date the form. The appropriate University Official signs and dates the form after the guest has signed. The original is to be held by the Unit and a photocopy to be given to the Presenter. The original is uploaded as supporting documentation to Non-PO Invoice.