Irs Gift, Prize Or Award Nomination Form
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1GIFT, PRIZE or AWARD FORM
Gift, prizes, and awards are considered taxable income per the IRS and must be reported as income to
any recipient. This includes, but is not limited to: gift certificates, gift cards, cash, and other non-cash
items. Use this form to report recipients of gifts, prizes and awards. Do not use this form for requesting
reimbursements of gifts purchased. Such requests must be made on a Check Request. To avoid delays in
processing, please provide the information requested below immediately for any individual recipient.
Recipient Name _____________________________________________________________
Recipient status (check at least one box below and provide the appropriate ID number):
□
1
Employee
EMPLID: _________________
Send completed form to Payroll Department, Campus Box 1000.
□
2
Student, Fellow, Resident
Student ID:____________
or EMPLID: ____________
Send completed form to Tax Department, Campus Box 1034.
□
2
Nonemployee
Social Security No: _______________________________
Send completed form to Tax Department, Campus Box 1034.
Non-employee Home Address __________________________________________________
City ________________________________ State___________ Zip Code ______________
Reason for Gift, Prize or Award __________________________________________________
Date of Gift, Prize or Award _____________________________________________________
Description of Gift, Prize or Award _______________________________________________
Value of Gift, Prize or Award
_________________________________________________
Account Number Charged for Gift, Prize or Award ___________________________________
DEPT-FUND-BUOB
Submitted by ____________________________________
_________________________
Department contact person
Contact phone#
1
The value of gifts, prizes and awards provided to employees, including student employees, will be added to
employees’ Forms W-2 for proper IRS tax reporting.
2
The value of gifts, prizes and awards provided to students, fellows, residents, and other nonemployees will be
reported on Form 1099 if aggregate taxable payments received by such individual exceed $600 during the
calendar year. Please note that taxable income for US tax purposes provided to nonresident aliens (NRAs) is
subject to 30% withholding under the Internal Revenue Code. Gifts, prizes, and awards given to NRAs will
be subject to a gross up which will be charged to the department providing the gift, prize or award.
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Parent category: Business