Purchase Verification (PV) Form

Submitter Information
Please login (top right) with your UCB IdentiKey via SSO if you have one.
Primary Affiliation
One file only.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
If you’re a student who has received permission from a faculty member to create a purchase request, create a request for reimbursement, or to request approval to travel, you MUST include in the email section of this request, the email of the faculty who has authorized the transaction, so that they receive a copy of your request form. Forms submitted without this information cannot be processed and you will be asked to re-submit your transaction.
Request Details
Type of Request
Request a reimbursement, the transaction is already complete
Request the department to place an order on your behalf
Reimbursement Details
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Is this being filled on behalf of someone?
I will provide their contact information
Select an Option
Home Address
Reimburse To
Purchase Description
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Agreement
Sign above
For the purchases listed above, I certify that the transactions were all purchases for University of Colorado business and that no personal purchases were made. For sponsored project purchases, I also verify that the cost is reasonable, allocable to the project, and that the item(s) will be used only for the project listed.
CAPTCHA
You are not logged in, please complete verification.