Report of Non-Monetary Exchange Form

For further details, refer to the Non-Monetary Exchanges policy.

On what date did the NME occur (MM/DD/YYYY)? *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Section 1

Description of goods and/or services provided by the University of Illinois System to the external party: *This question is required.

Estimated fair market value of goods and/or services provided by the U of I system to the external party: *This question is required. This question requires a valid currency format.

Associated Banner C-FOAPAL(s): *This question is required.

Chart This question requires a valid number format.

Fund This question requires a valid number format.

Organization This question requires a valid number format.

Account (Revenue)

This question requires a valid number format.

Program This question requires a valid number format.

Activity This question requires a valid number format.

Location This question requires a valid number format.

Amount: This question requires a valid currency format.

Section 2

Name of the external party: *This question is required.

Description of goods and/or services received by the system from the external party: *This question is required.

Estimated fair market value of goods and/or services received by the system from the external party and associated Banner C-FOAPAL(s):

This question requires a valid currency format.

Estimated value of goods and/or services and associated Banner C-FOAPAL(s): *This question is required.

Chart This question requires a valid number format.

Fund This question requires a valid number format.

Organization This question requires a valid number format.

Account (Expense)

This question requires a valid number format.

Program This question requires a valid number format.

Activity This question requires a valid number format.

Location This question requires a valid number format.

Amount This question requires a valid currency format.

Section 3

Do you have any other information related to this non-monetary exchange that you would like to share?

Contact Information *This question is required.

Department Name:
Submitted By:
Email:
Phone Number: