sendie are-ml' Reqiiesi for Scholaxship, Fellowship, or siipeiid Payment Fax (703) 993-1539 lnmueiinne I/mi ii Ill pay nepamnenml miion 0/ Merit sclinlimliip. nap nan. Um me nepamnenml ruiliaii Grail.' Farm. If/Ilzr: ir a Walk lo iliis award, mp am. Sllpimfs mlullmlo: mvieei niim be processed zmugn Payrall and not an this farm. neelpienie must be paid market hourly me roldzud. Pnepatz a/nmifar eaeli award reelpienl. supply me name a/ilie ielmlarmp,/e/limah/p, nr rtlpend, l_/applmable, or organization and accounl to be charged Five aeeimni codes in me 755;" saris: Apply [0 (I113Payee L, US citizen/pennanenl resident visa holder Name: _s 'd Tun./Ius7vll) i 7* gooll_o_l2l visa category (ma and (I copy oflhe Award Vzlter lo Q[/inc mgienii ei Servlvu us>> 40; Address: . HP pl 20371 For use by omee Only: 1 Tax Nei za Payee oeposii wiililield ia M114 25| I3. Relum checkm depanmenl [1 MSN Date Submitted 05/22/07 Infonnation Amount' S2 500 Name (of July I 2007 cos lB210l mi . Point Enos Phone - Approval loertify iliai ilie above ieqiiesied seliolaislilp, fe1lowship,or stipend pa'/merl| is a grant awardzd in aid ieeipieni in the of his/liei or ieseaieli. This pnymenl dues ineliide eoinpeiisaii for aervieei lai ilie lienem al George Masiin unlverally.11ie and approving omeial acknowledge Ihat any laxes, penalties, and/or assessed la GMU, lnliis payment is deemed In be for services, will be charged (0 the awarding depanmenl named on ilils roini sigiiazii (Or iianie Date ewi es; 5/131'? ofap roving emeial rai fund/org Tiile We (MSN 305; and I copy ie Olficc Aid ms); keep a copy {oi my 2005 EMMJ uh/ML'? institution when the training of a fellow involves extraordinary costs for travel to field sites remote from the sponsoring institution; or, accommodations for fellows who are disabled, as defined by the Americans With Disabilities Act. The funds requested for costs of this nature must be reasonable in relationship to the total dollars awarded under the fellowship and must be directly related to the approved research training experience. Such additional funds shall be provided only in exceptional circumstances that are fully justified and explained by the sponsoring institution. Awards for training at a foreign site may include a single economy or coach round-trip travel fare. No allowance is provided for dependents. U.S. flag air carriers must be used to the maximum extent possible when commercial air transportation is available for travel between the United States and a foreign country or between foreign countries. Funds are not provided to cover the cost of travel between the fellow's place of residence and a domestic training institution. However, in cases of extreme need or hardship, a one-way travel allowance may be authorized by the sponsoring institution. Such travel must be paid from the institutional allowance. Facilities and Administrative Costs. F&A (indirect) costs are not allowed on individual fellowship awards. SUPPLEMENTATION OF STIPENDS, COMPENSATION, AND OTHER INCOME ^$Ho3-0li1 * The sponsoring institution is allowed to provide funds to the fellow in addition to the stipends paid by the NIH. Such additional amounts either may be in the form of augmented stipends (supplementation) or in the form of compensation, such as salary or tuition remission for services such as teaching or serving as a laboratory assistant, provided the conditions described below are met. Under no circumstances may the conditions of stipend supplementation or the services provided for compensation interfere with, detract from, or prolong the fellow's approved Kirschstein-NRSA training program. Stipend Supplementation: Supplementation or additional support to offset the cost of living may be provided by the sponsoring institution. Supplementation does not require additional effort from the fellow. DHHS funds may not be used for supplementation under any circumstances. Additionally, no funds from other Federal agencies may be used for supplementation unless specifically authorized by the NIH and the other Federal Agency. TcVVaiA^^Y/' ' ' Compensation: The sponsoring institution may provide additional funds to a fellow in the form of compensation (as salary and/or tuition OrtrV " \NX'V1^ remission) for services such as teaching or serving as a research Y . assistant. A fellow may receive compensation for services as a Q/tTi^' research assistant or in some other position on a Federal research r fiWv grant, including a DHHS research grant. However, compensated services \~K/-^J should occur on a limited, part-time basis apart from the normal research training activities, which require a minimum of 40 hours per week. In addition, compensation may not be paid from a research grant supporting the fellow's research training experience. Educational Loans or G.I. Bill: An individual may make use of Federal educational loan funds and assistance under the Veterans Readjustment Benefits Act (G.I. Bill). Such funds are not considered supplementation or compensation. Postdoctoral fellows may also be eligible to participate in the NIH Extramural Loan Repayment Program. Information on this program is available at http://www.lrp.nih^qov/ concurrent Awards: A Kirschstein-NRSA fellowship may not be held concurrently with another federally sponsored fellowship or similar Federal award that provides a stipend or otherwise duplicates provisions of this award. sum AOCONIIS Paynbl: VISN 35-' Request for Scholarship, Fellowship, or Stipend Payment Tel. (103) 993-2530 Fui (703) 993--25fl9 Inrtruclimu l_/this Ix Ia pay a Grunt ur Mcrit smlmiup. xlop rwvv. us. M1 Dcpamrmiml mini>>. Gnu Farm. a ma In this award. I/op now. Slipmdx that xerviczx rendered must beprocesud Paymll and nut an /om Rzcip/ertls mm be paid A/air Inarkzl handy ml! Prtpare afimvlfu am Armani recqalenl. Supply ma mun: afrhe Dr Stipend, I/appiicam. and M:/wtd ar and armulu as be mi-nit Hr: digil iumurll mitt: in the 7(l?xx reriu in M11: and an ml Iht Kilt at rs Payee Infomiation: Check one: us ciliun/pcrmanenl resident Name: Said. Yasmin visa holder Visa number: G001 1012] Ojiue a/immanmi 4 imiau Am ICJI Address [nnmbu Ind Clarksburg, MD 20371 mu. nip)" For use by oirsmp Olfice Only' I Tux withholding Nu Amalml Iu Pnyee De-posii lulu withheld In I4 251 I3 Retum check in department Dale Submitted ()5/22/07 Scholarship/Fellowship/Stipend Infonnalion I Amount. szsoo Awarding dtpamnenl: Comp. Daia Sclenccs cos rim/org: Accounx: 73; 57 Puintolconlacl: aims E-mail 1 Fax: oi/ia,{ i. a. .. up Lo' Approval cenify max me above mquzsled scholarship. Mlowship. or stipend is a grim! awamaa In mid recipmll in pursuil afhiS'heI or research. 'rm; does not fur strvices for Ihe bcnefll of Georg: Masai: . The undersigned ieqiiasm and approving official than any xnxes. penallies, and/or imeiesi GMU. ilrhis payment is dremed In be for services, will be charged lo we awarding named on this form 7- Omir ab We Signalu orrgquefioi Primed name Tixl: rgynir Qb? sigiianm ufappraving oflicvnl for l'und'org Printed name Tlil: 17*? Disinhuimn Send onginnl io Accaunis Pa} nbl: 3C5) and a cup) in Omoe of Suidrni Fimncizl Aid (MSN 3B5). ktepzcup} for MH7 hifilnu-GE 305 Requesl for Scholarship, Fellowship. or Stipend Payment run l7liMW3-2530 lax mm 991.2539 Irutrmiilalli Iflhil ix la pay Grant ur Mn-it Schalarsllip. flap rurw. U3: Iht Dlhlolv Grunt Form I/that a wart mponun In um award, Mop Imw. Svlpiwlx mu mnxlilula man be pm-mm Payroll and mu an um Redpiznu mm .5: [Mid falr numi hourly rult o/pny /ar mu-lemt mu award suppiy Ah: mi. 0/ill: al mpo-4, I/applicable. and at nnu uwlml ia be climax nu azpu avwunl main in ms um sol}: nppiy 117 mu and are on the anion: Accaunllrig web we Payee Informalionz Check one: us Icsidcnt Name: Said, Yasmin um. Mn Visa category 0 number: (3001 10121 Ilemltomdtled/arwl and; (apy Mn: lull! la Oflm MSN ICJ) Address: -- and slmci Ell)' sun. zip) Claiksburg. MD 20871 For Us: by omcz Only: Fix withholding Nu Ia ye: mtes wilhlleld in MI 14 25113. Return check to depanmem Date Scholarship/Fe|lowship/Stipend Information 2007 Amount: szsoo Awarding comp. &_DalA Sciences cos Fund/Org: 3; 9 Accounr 155:5 Pom! ofcuntaci Kalhleen Enos E-mail Priunc Fax: 2 Approval I miiry lha| ahovn requesled scholalship. fellowship, at slipend payment is a yam awarded (0 nia Ihe rccipiznl in me pinsnii of insmer s|udies or reszamh. um um include compennlinn for services for the bench! in! George Mum: University. The mqueslor and approving officinl acknowledgt that my taxes, and/or assessed in GMU. inins pnymuil is dcemzd to be fur services. will be chaxgcd In the awarding depamnenl nninm on this form iumifawjg. Ckm" (3 Signalnr tor Tiile Chair 5'/'lgla Signature oi approving official for fund/org Printed name me Date Dislribulimr Send original In Accounts 3C5) and a mp) In uf Student Financial Aid IE5). um} In! mum; mm 1 1 1 '7 sennm Aosnunispaysbis 1 M51 K5 Request for Scholarship, Fellowship, or Stipend Payment Tel. 17031993-2530 I-'ax 171111993-25149 ln.11rm1lnIu (film is in pay a (Iran! 07 Ila]! nmv. Use the Tuililm cm Fm-In I: . mi mnpoomii In this want, my um Stipend>>! um smicu may processed Illmugk Paymll and not an um farm kuiyiznu nun be palda [117 mm; him rly ml: afpiry for szn-Ice: miaemx Prepart u/mi/in cud! awarl r?'dpi'znL sum, the uni. oflht or xl/pend. and lhtfumi HI inganlzallim and to be digit atrium! cmIt.\' VII 01! 735)" rtfiu apply In Illa: payment. and an available an ill: Gtneml II Payee lnfonnatioiiz Check out: us residem ga;d_ yasmin Noniinmigrant visa holder 11xs1,T1nL Mn Gnumber: 000110121 Name: Visa calegory anrla ('way award 1.. 03121: 0/Inltma/mm! A MSN 41:3; Address: and $lIcz|,lpI .c11).s1Ile.1ip} Claxksburg. MD 20871 For Use by (Mfice Only Tux nmonm Io 3411425113 Retum check Io department Date Submitted: 05/22/07 Scholarship/Fcllowship/Stipend Infonnalion Name (of 15 2007 Amount: S2 500 Fund/Org' 1:2 9 Aocounlz E-mail: Phone._ Fax: Awarding depanmenl: Comp, Data C08 7 Approval lcerlify mm the above rrqueslzd stipend pmymenl is a gram awamed lo and the recipient in ms pufiuil ormsmu studies or research. This plymenl um um Include colnpulnlinn my services < - .. < y, ma mg l./mil /0 305 Request for Scholarship, Fellowship. or Slipend Payment Tel. mm 993-2580 Fax' I/mix Is In [my :1 Tu/Ilan Ur mm Scluzlarsllip, mp now. Us: the Tulrlan Gram Farm. Iflherr I: a work inn award. flap mrw. Stipend: Mal paymtilrfar urulctx remizrtd must be run an we [aim Rulpiznl: muxl hrpald a/all mm: hourly ml: o/pay/nr xervlcu rtmlerell. [arm ma ward reclplenl. Supply me rinm: aflhe scnolulilflujellowship, at i/applicable, and uie/mm er and account in be charged. Five dlgli aavutnr mm in M: mm mm upply In ml art on me GmeralAu'0unIlng siiz .2: I C9 Payee Information: Us residcni Nonirnmigranl visa Check one: EB U0 -P Nalnc: Said' Yasmin 1I.m.fim.Mn Visa Cmcgun number: (7001 10121 fwrnanda n/me ammllelicr In Ufiw Program: Svrvuvr Adm Clarksburg. MD 20871 For use by OWN: Only Tax wlihhaldirig Nu IL) Pnyce Rclurn check to Depusli mas Io 841M 25| I3 Dale Submiucd: 05l'22/07 Schulalship/Fcllawship/Stipend lnformaiion Nume(of? my I5 2991 Amounl: szsgo Awarding depanmenl' Dala Sciences. cos runwoi-g. iglol Accounr 15515 |"oinlufcon|acl. icnilileeii Enos E-mail: 1 Approval I certify Ihal me above scholarship, fellowship, or snpend ls a awarded In aid lh: recipient in me pursuii ufhis'hersludi or research. This paymeul does nol include culnpensmiun for servlees tonne nenern or George Mason Unive .Tne undersigned iequesiorand approving official acknowledge that any Iaxes. penalties, lmcresl lo GMU, playmenl is deemed 10 be for will he charged to the awarding department named lm form. n" 7 Primed name 3/13 /0 1 Signalur: lrreane or 03 Uh') al for (livid/< In' Payable Request for Scholarship, Fellowship. or Stipend Payment Fm mmws-2539 C30 If/Iii; is in ll Tulmzil (min: or mp naw. l/re Dzparvnenlal Tullian Farm. I: a la mi. slap nan. linn payrutnl far mninnl mm! Ire pmtusttl Ihmugh l-n_nnll lm Iltlx /am Rcri'pl'ellI.r mm! A: /mid a filir hnarry rm: lifpayfar mnim Prtpare a [arm for each supply Ill: nann 0/ the /1-llows/lip, at nip>>-d. amt nnu ulscalml la on rm digit ammn: llrles in the ma mm apply lu mm paymaerllx. and are available an inn Armunling web we al Payee Information: L's resident winniniginni visa holder U7 Check one: -C Name: Said. Yasmin mi>> visa meg", num ber: 0001 I0 I 21 (mid cllm/A/tierlform and a L'lA[fl' uf/ho lam la ([075: a; Plugmrm 4 sm-mi 463/ Addres in lLx,lml. Clarkshurg, MD 20871 For Use by omce Only: Tax Ne| lo Paye: Relum check to department L. Depmli wiihlieid In mi 25113 Date Scholarship/Fellowship/Stipend Information Nam: JS) OcIubcrI,1j)07 Amoulil: $21500 cos Fund/Org: l82l0l Account: PoiII|ofconlat| Kiir|iI:enEn9s E-mail: _j Phone. Fax' Appmval i ccnify lhal abovc scholarship. raiinwsinp, or sripcnd paymenl is a glam awurdcd lo aid the recipient In line pumm ol in>> in-i nndies or rcscaich. This payinenl does include compensation for services for the benefit or George Mnsun Univcrsi .T|ic undersigncd requester and approving oflii.-ial acknowledge Illa! any Inxes. penaliies. anchor mlercsl messed lo emu, inliis IS dumed Io be for services, will be lo til: awarding depamnml named on Mia iorm Pm.' cu3SB\ ND QM 'D?n Sigvmlur i>'lnned naine rill: Dale Signature ufilyinruvlng amciai for fimd/org Printed name Title We Dismmluuvi S;-rid original In Accmli-in Puynliln: IMSN JCS) and 3 copy Io Oflicc of Slulklii Financial Aid (MSN kcup com in drpanincnl 1006 lien, 4/ 'End to Payable 3C5 Request for Scholarship, cllowship, or Stipend Payment lel lax /r I0 pay mrinn (Iran! or Merl! nap nnw. U3: me Departmental Tuition Farm. [mm 1: in work In mir nnrmi, nap Siipend; um mrrimd mun llmzagh Faymll and nut an inn /arm. Ilecfpiwllx mm! he markzi handy me urvlces rendered. Preparz ajnrm/ur each award rzcipiznl. Supply the 4/ft/re nr nipuni. iynppiimnir. and Ill:/mid or and accnunl In be charged rm 4 I citric! in [hr 735:: Aerie: apply In and Ill! available on the web site All Check one: Payee US cirizerupennanenr resident Name; Said. Yasmin 1 Nunimmigmm visa holder SISSJOQ (Ins! Iirsx. MI) visa Category number: (r001 1012 I artda uwaullemr/0 Ofiize :1 Scrvizvx HEW amt. Clarksburg, MD 20871 For Us: by umrc Only. Tax wiihholding 7 Na urnuuin Io Faye: Return check In MSN Depnsii Iaxcs Io MI 14 ZSI Date Suhmiucd: Information Name \'ofS'F'Sv. October I5 2007 Amnunl. S2 500 cos rundxorg: gzigi Account 7551; Poinl of cunmrl Kalhlcen Enns Phone. fl Appmval I cemfy aim icqnesled scholarship. fellowship, or slipznd payment is a gram awarded In aid the mcipicm in the purauil of1iis'h:r sludics or research. This pnymenl does not include compensatlou for services Ihe mum: of Georg: Mason lfniversily. The undersigned rcqucslor and approving official acknowledge ma: any mxes, penalties, and/or assessed to cmu. iflhis payment is deemcd |0 be for scrvices. will be charged the nwmiing dcparlmeut named on farm /(57 Amao Sigilmurc Tiile Dine Mr. Claw/' Signmurc {approving ommi for Primed name Title We Di)|ribunun 9s'nd angina} Io Accounls Payable (MSN Lopry |o OITICC of Sludcm Financial Aid May 2005 Printed name op} Iur dcpunlxwill 4-1 X0 I fiumufi W3-2580 Request for Scholarship, Fellowship, or Stipend Payment lax (703) 993-2589 DISIVIICIIODII I (fun is In pay 1. union or Mail 1-mp mm. nu Drparmrnul Tultlon Form I/Inn: It a mark camponm: lo Ihlx mud. slurp Mw. Sllpoulr um nrvitu mitmd mu llmugh Payroll and not an my form Rrcipimlx mm be pail :1 /nlr mum hourly rm 0/pay fir mp." aforrnfur mall n-ant in: name aflne rllpund. Int lhtfund or and ammu to be charged nu digit arcuunl codepaynmux, am an an an Gnizml Ivtb me .-- - US resident Name: Saki yasmin Nu-nimmigl-am visa holder firm Mn vim meg" Gnumbcr: G00n0l2l Oflkv 4 usw SIM: ipi Clarksburg, MD 2087! Payee lnfurmation: Check one: Addrc rm Us: by Ullice On - Tux wimnoiding Ne: Imwnl lo Plyce Deposil um withheld In 4 25113. Relum check to depmment Date Submitted: 05/22/07 Scholanship/FelIowship/Stipend Information 2007 Amount: S2500 Awarding dcpanmenl: Camp. &Dan: Sciencts cos Fund/Org: 5; 9; Accomnz 73?l? Pmnkufcunmcl: Kathlgen Elms E-mnil: Phone: - Approval I certify that the move mquesled fellowship, ur stipend is a yam nwudtxi lo aid an recipienl in the pulSuiI of him: slndics or rnsurch. This does nol Include for far the imam ul Georg: Muou The undersigned requeslor um lpproving nfficinl acknowledge <<95 Signalurc fapvroving nmclal for fund/org Primed warn: Till: DEW Send original to Acmunls (MSN 3(5) and I curvy Omcc of Sludcnl Financial Aid (MSN mp a cum Yovdcpanmcvil moms my mm Dingo!-E Request for Scholarship, Fellowship. or Stipend Payment m:no3199;mssy I ma, Inmuulana If-nu xx Iapty a Tuition Grant nr Mm": mp mm. Ur: nnuon Grunt ram mum is . convoamu um man. up now. sup:-us um mourllulr urvlca rwldemd mm pmmna Ahruugh And not an mm [mm neapiuu: man be paid lfizlr nurna nanny mu ofpqv/nr wvica rumemt -I/amlfol gun awlni sappy 5? none I/nwumue, nu lht/and at and accuunt to be rm mg-'1 utcuunt soda in M: 7551:: son: nu ma. mt an an the wt: 31!: Payee Infonnalionz Check one: Us Len/pennanenl resident Name: Said. Yasmin visl haldzr umnm. Ml) visa "weary Cy number: G001 l0l2l om': 0//rtkmatrarnl A MSN Address nn . MD 20871 For Use by OIPSIAP Oilice Only. Tux withholding Net unmnl to Pnyoe Relum check to department 4 Deposll uxes wilhheld lo I 25 3. Date Submitted: 05fl2/07 Scholarship/Fellawship/Stipend Information Nam: (urs/F/5): November 15 1007 Amoum; S2500 Awarding depanmml: Camp. Dana Sciences'COS Fund/Org: 131101 Aocmm: lmi Poinxorcomacr. _K3:1hl:en Enos E--mail: -- rnx: Phon Approval I cenify man the above rtqueslcd scholarship, fellowship, or stipend payment is to Aid me mcipienl in the pursuit ofhis/her studies or research. This payment does not ancnnu compenullnn fur servku for me of George Mason Universily. The mqueslorund Iupmving official acknowladge mu any um. penulliesn and/or mlcresl assessed In (mu, if this paymenl is deemed be an servicus, will be charged to me awarding depmmem named on form 5/25 /32 A95 g3? Slylarure r:quc Printed name 'ring D: 42? cm Q5 5/93/07 :2 49>> \h;pu o; sugnnum approving official for fund/org Primed Tine Dislribul Stud lo Accannxs Pnyable (MSW zcs) cvpy Omcc of Md (MSN 155). mp .. mm "words. my 20% l2? and and 1C5 Request for Scholarship, Fellowship, or Stipend Payment Tel: (703) 993-2530 my, 0 u\ 3 Fur (ml) 993-2539 Inxrmaim a Tuition Gnu: or nap Mn. Illa Gran! Farm I/lhrvell amwmi In an mud. nap mm. mm; um (walnut payment remierrd Illa! uimpn r-ymuuid my on /mi. Recipitnlx Inuu mi-nu nouroa mt: afpru/or servlru Pnrpare mu mun! Supply in mun: njrhe or uni Ill:/Mild or and ucaaml lo charged. 4 nocmml unit! In 735:: min appty ihzupapuenu. anlau awllabl: on All: we: :41: :1 non Check one: Pay ee Information: us citizen/pennancnl resident Name: Said. Yasmin noudu um rim. Mn Visa ca,,gm,y number. G001 l0l2l upiix 4 Qrvlul MEN Clarksburg, MD 2087] For Use by omue Only: Tux wilhholding Na amount to Pnyec Relum check to departmenl .j Dcposn Lixr.-1 Inlwl 25113 Date Submiued: 05/22/07 Scholarship/Fellowship/Stipend Information Decen_I_b_erl 2ou7 Amounl: $2 500 Awarding Sciences cos Fur|dlOlg: 52 9 Accounl: 13; 5 Poinunfcmiuci: KLin=gn Enos E-mail: Plum FIX: Approval Icemfy me above requesled fellowship. or siipeiid is nwuded lo lid the recipient in the pursuil Ofhls/llcr sludics or resemth. dots um include cumpenulinn (or (nr the n! George Mxsuu Unlversilyi The undmigued mquzsmr and approving omciul acknowledge man my um, pennlties, and/or interest assessed (0 GMU. ifmis payment is dccmed be {or services, will be charged [0 me named on mus fonn 5&5 515/01 sigu?iurc frequ Printed nam: um 329%?' 5253/5+ Signature ofapprovlng olficial for fund/org Printed mic Title D-W Send lo Plyablt (MSN and I wpy In Olfiue of Student Financinl Aid (MSN 335); keep :4 cup>> For records my 2006 am. seudm C: 7" U7 Request for Scholarship, Fellowship, or Stipend Payment Fax-ivozim-2539 I Irmructluns 4/rur ll to pay . nepamnenm cmri or Mull srnaimnip. my now. use use Tuillun am: ram I/um: It a wet congwnuu la rur Award. nvw. um rrnlurd mm be and mu an /om mud paid -/ur marlin nanny rule o/'pay/nr rtmirrat Prepare ufunn/nr euh awvd sappy Ill: rune o/me ornlpend, llitfumt or argauizamur and nccounl to be rive dun lccauu cadet In in 735;: runs uppty to and art -vaunue an me Genzrul me a! Payee Information: Check one: US cirizerr/penriarieru nesidznl Nmummigmnl visa holder HCO ht Name: Said' Yasmin ursr. Hm. Mn Visa number: G001 10121 mlueapy Dmn: A Servicu MSN IC3) Clarksburg, MD 20371 Addres For Use by Uffio: On|y. Tux Nei Iuununl lo Pnye: Deposir mr wilhheld to 341 I4 251 I3. Return check to department Date Submilled: 05/22/07 Scholarship/Felluwship/Stipend lnfon-nation December is 2007 Amuum: S2 500 Awarding Colnp.& Dara Sciences cos Fund/org. iszioi Account: 1351; Poiniofcrmiaci E-mail: -- Phone - Fax' - Approval 1 unify mar In: above scholalship. fellowship. or stipend payment is awuded ro aid me recipient in are pulsnil ufliis/her srudies or research. This ptymenl does nol include eompensninu {or tar me or George Univznily. The undersigned requesmr urrd Ippmving official mu my rum. perrulnies. and/or assessed In emu. iruris paymzm is deemed to be services, will be charged are awarding depalmu-.nl named on Ihis form cfi 3 Tirie Dal Primed rum: 2 C"n4?iI CV) sigrmurre of approving oflicial ror fund/org Fnnted Tiile Wt |)ItIrihul|m\ Sum original to Accounts Payable (MSN JCS) and cup) In Omce of Sludenl Flnallcill Aid IMSN 33 Keep com for dcprarlmcill records lama him'