Get Ca Elarc Request For Payment - Transportation 2017-2025

The CA ELARC Request For Payment - Transportation form is a crucial document for individuals seeking reimbursement for transportation services. This guide provides clear and detailed instructions on how to complete the form online, ensuring a smooth submission process.

Follow the steps to successfully complete the payment request form online.

1. Click 'Get Form' button to obtain the form and open it in your preferred editor.
2. Enter the name of the person served along with their Unique Client Identifier (UCI) number in the designated fields. This identifies who the services were rendered for.
3. Indicate whether the payee is an employee by checking 'Yes' or 'No'. If 'Yes', fill in the employee's name and identification number. If 'No', treat the payee as a vendor and ensure a W9 form is completed and submitted.
4. For a vendor payee, enter 'Make Payment To' with the payee name and provide the mailing address for the check or paystub.
5. Provide the payee's phone number for any necessary follow-up regarding the payment.
6. Fill in the date of service using the format Month, Day, Year to specify when the transportation service occurred.
7. Input the total number of miles or trips for which reimbursement is being requested.
8. Multiply the total number of miles or trips by the approved mile/trip rate to calculate the total payment amount. Ensure this is clearly documented on the form.
9. Sign and date the form to attest that services were delivered and received according to authorization. If this is the first payment to the vendor, confirm that a W9 has been submitted.
10. After completing all fields accurately, save your changes, and choose to download, print, or share the form as necessary for submission.

Complete and submit the CA ELARC Request For Payment - Transportation form online for efficient processing.