Coronavirus Financial Impact
NOTE: Where possible, code incremental expenses to account 951770 (COVID-19 service expenses) or 932310 (COVID-19 supplies/materials) and refunds to account 104010 (COVID-19 sales & services refunds). For transactions recorded as noted above in Banner, do NOT use this form; reporting those items on this form will result in duplicate records.

This form is to capture the financial impact directly related to the coronavirus (COVID-19) outbreak. This includes incremental expenses (such as penalties to change airfare or COVID-19 supplies needed), sunk cost expenses (such as non-refundable airfare to attend an event that was canceled), and lost revenue (such as retail sales for a dining venue that was closed in response to the coronavirus). Please note - For non-refundable travel arrangements, the employee should request a refund because we are having some success reducing the financial impact; some providers are being more flexible than usual under these highly unusual circumstances.

At this time, we're not aware of additional funds to cover these losses. The information is needed for reporting purposes and in the event that any alternative funds become available.
Email address *
Type of Financial Impact (see introductory paragraph for explanation of types) *
Name of Person Submitting Form *
Work Phone *
Division *
Department *
Date of Occurrence or Expenditure *
MM
/
DD
/
YYYY
Description of Occurrence or Expense *
Actual Amount of Expense or Lost Revenue *
Fund Number Charged (if unknown, use "xxxxxx") *
Account Number Charged (if unknown, use "xxxxxx") *
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