UVa or State Funds Study Payment Procedures
Form
Protocol Information
IRB-SBS Protocol Number (assigned by SBS
office, leave blank):
Protocol Title:
Principal Investigator:
Using this document:
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The purpose of this form is to provide supplementary information to the Board regarding your
payment procedures. Any human subject payments requiring the services of UVa’s Procurement
Services Office for payment by check, cash or gift requires researchers to follow Procurement Services
accounting procedures for tax and record-keeping purposes. You should only complete this form if
you are using UVa or State funds (including outside grants) administered through the Procurement
Services Office to pay participants in your study. This form does not apply to researchers using
personal funds for subject payments nor does it apply for participants residing outside of the United
States who do not have a social security or tax identification number. If you have any questions
regarding payment, please see Paying Participants on our website.
This form describes several scenarios for paying participants. While Procurement Services would prefer
to have all participants paid by check through Oracle, this method does not match every study
scenario. Please mark the scenario (#’s 1-4) that best describes your study and provide additional
details about how the payment process will work in your study. You only have to respond to the
scenario that matches your study; please leave all non-applicable options blank. If you have multiple
participant populations with different payment procedures, you can mark multiple categories;
however, please clarify which payment procedure will be used with the various participant populations
(and make sure that this coordinates with the information provided in the protocol form).
The key concern with paying participants is whether or not collecting the information needed to
issue a check through Oracle (i.e. name, address, social security number/tax identification number) will
be a confidentiality issue for the participant. For studies where the participant’s name can’t be linked
to the study, we have a mechanism for keeping this information confidential when it is reported to the
Procurement Office (see option #2 in the form below). For studies where identifying information
cannot be collected or for which the research methodology makes it impractical, payment to
participants must be $50 or less over a twelve month period and a justification must be supplied (see
option #3 in the form below).
Submitting a protocol:
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This document should be submitted with your protocol. To submit, complete this document and email
it and any accompanying materials (i.e. consent forms, recruitment materials, instruments) to
irbsbs@virginia.edu. For more information on what to submit and how, please see Submitting a
Protocol. Please note that we can only accept forms in Microsoft Word format and in this form only.
Do not submit your responses in a separate document. If you need help using our form, please
contact our office.
Revision Date: 09/01/11
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1. Payment is issued by check through Oracle or other State system.
Please identify the participant population receiving payment by check and include the payment amount.
(For example: All the study participants will receive a $25 check.) Please note that you are required to
collect the participant’s name, social security number/ tax identification number, and address in order to
issue payment through Oracle.
Response 1:
2. Payment is issued through Oracle or other State system but the participant’s
identity cannot be linked to the study name for confidentiality reasons.
Please identify the participant population receiving payment by check and provide a description of the
procedure for collecting participant’s identifying information and paying participants. Provide justification
as to why it is necessary to pay participants in this manner and include the payment amount. Please note
that you are still required to collect the participant’s name, social security number/ tax identification
number, and address in order to issue payment through Oracle; you will be provided a mechanism for
reporting this information that will still protect participant identity.
Response 2:
3. Payment to each participant is equal to or less than $50 over a twelve month
period and payment is issued in the form of petty cash, gift card, or other item.
This method is used for studies where the participants’ tax information can’t be
collected for confidentiality reasons.
Please identify the participant population receiving payment and then describe the type of payment and
procedure for paying participants. Include the payment amount. Justify why it is necessary to use this
method to pay participants rather than issuing a check through Oracle.
Response 3:
4. Payment to each participant is greater than $50 over a twelve month period,
payment is issued in the form of petty cash, gift card, or other item, and
participant identification can be collected for IRS purposes.
Please describe the procedure for collecting participant’s identifying information and the procedure for
paying participants. Provide justification as to why it is necessary to pay participants in this manner
(versus using Oracle) and include the payment amount.
Response 4:
Revision Date: 09/01/11
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