Fiscal Sponsorship Disbursement of Funds Request

Fiscal Sponsorship Payment Disbursement

Use this form as a fiscally sponsored artist to request funds from your account. Payment will be made within 5 business days of the request submission date.

Name on file to disburse funds to (individual)

First Last

This is the entity to which the check will be written and who will receive a 1099 at the end of the year. Please be sure that this individual has both a contract and a W9 on file with us. Otherwise, we will not be able to issue the check.

Name on file to disburse funds to (business/group)

This is the entity to which the check will be written and who will receive a 1099 at the end of the year. Please be sure that this entity has both a contract and a W9 on file with us. Otherwise, we will not be able to issue the payment.

Payment Method(Required)

Check - Mailed via USPS to address on W9

EFT - through Nickel (new)

Have you set up an EFT/Nickel account with Studio at 550 yet?

Yes

Note: As of 12/31/25 Studio @ 550 has changed payment processors from Melio to Nickle. Once you fill out this form and we initiate payment you will receive a preliminary email to set up a vendor account by entering your payment details. Once we receive this information we can initiate payment through Nickel.

Address to send the disbursement to

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Contact Email(Required)

Additional contact email

If there is more than 1 contact in your fiscal sponsorship agreement, email of both parties in the contract must be entered here. Both will receive correspondence about this notice and future disbursements.

New process for year-end 1099 reporting (effective 12/31/25):
Disbursement requests are now divided into two itemized sections based on IRS reporting requirements:

1099-reportable payments — payments to individuals for direct support, stipends, honoraria, or services
Program expense reimbursements — reimbursement to individuals for documented, program-related expenses (not reported on a 1099)

I am requesting funds for

Payments to people (may be 1099-reportable)

Reimbursement for documented project expenses(not 1099 income)

select all that apply

1099-REPORTABLE PAYMENTS

(Direct Support / Stipends / Honoraria / Services)
Use this section if you are requesting:
Direct financial support
Stipends or honoraria
Payment for labor, services, or artistic work
Funds not tied to specific receipts

Date to be Disbursed (1099)

Please note that a check will be written to the name/W9 that is on file within 5 business days of the 1st business day of receiving this request.

1099 Payment Amount

Description of what the funds will be used for

Required Acknowledgement

I understand that this payment may be reported as taxable income and that I am responsible for any taxes owed.

PROGRAM EXPENSES (Non-1099)

Reimbursement for supplies, materials, or other approved program costs you already paid
Advance for project expenses based on quotes (funds will be spent for approved program purposes; receipts must be submitted afterward)
This cannot be payment to people — including yourself. If this is compensation for time, labor, or a role, use the 1099-Reportable Payments section above.

Date to be Disbursed (non 1099)

Please note that a check will be written to the name/W9 that is on file within 5 business days of the 1st business day of receiving this request.

Payment Amount (non 1099)

Non-1099 Expense Category

Leaving this form blank will void the disbursement request

Supplies & Materials

Equipment Rental

Space Rental

Travel

Advertising & Marketing

Insurance

Repairs & Maintenance

Utilities

Other (requires a description below and a receipt)

Include what was purchased and how it supports the project.(Required)

Quote/Receipt Upload

Drop files here or

Max. file size: 256 MB.

If submitting a reimbursement, upload receipts for expenses already paid.
If submitting a project expense advance, upload quotes for expected expenses. Receipts must be provided after purchase.
All documents should clearly show the item, cost, and vendor (or description for services/materials).

Certification:

I certify that these expenses were incurred solely for approved program purposes, were not personal expenses, and are being submitted for reimbursement only.

If these funds were received through a grant, name the grant and funder. (Required if applicable)(Required)

We cannot process this disbursement against a grant that was not previously reported to us via the Notice of Incoming Funds form. If these funds are not from a grant — for example, a direct contribution — you may write "N/A."

Confirmation

I confirm that I am authorized to request disbursement of funds from this fiscal sponsorship account.

I confirm that the requested funds will be used only as described and in accordance with my fiscal sponsorship agreement.

Receipts/Unused Funds Acknowledgement

I certify that any program expense reimbursements or advances will be used solely for approved program purposes, and I will provide receipts for expenses or return any unused funds.

Payments for 1099-reportable items (direct support, stipends, honoraria, or services) and program expense reimbursements or advances will be issued as separate disbursements. This ensures accurate accounting and proper year-end IRS reporting.