Fillable University Of Oregon Employee Information Form printable pdf download

University Of Oregon Employee Information Form

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Complete University Of Oregon Employee Information Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

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Clear Form

Employee Information Form

Please return this form to your hiring department by fax or U.S. Mail.

Section 1.

To be completed by employee

Employee Name (As listed on Social Security Card.)

SSN

UO ID #

Last

(if known)

Date of Birth

First

Gender:

Male

Female

Middle

Oregon Retirement Plans: I am/or was a member of

Preferred First Name

PERS

ORP

Race/Ethnicity (completion of this section is optional)

Citizenship

U.S. Citizen

1. Are you Hispanic or Latino?

Yes

U.S. Resident Alien

2. Select one or more of the following races:

Foreign National (Non-Resident Alien)

Asian

Country of Residence:

American Indian or Native Alaskan

Mailing Address

Black or African American

Street

Native Hawaiian or other Pacific Islander

City

State

White

Zip

Nation

3. Racial or ethnic subgroup:

Home Phone

Employee Signature

Date:

Section 2.

To be completed by department

(After completion of Section 1 and 2, send to Payroll Office)

Campus Address / Phone Numbers

Employee Class

New Hire

Rehire

Rm No. Bldg

Monthly Appt %

Start Date

Zip Plus 4

If applicable:

Employee is transferring from

Campus Phone

OUS Institution / State Agency

Check box if Proximity card

Employee will be employed part-time at

(OUS institution)

required for bldg access?

Department Name and Check Delivery

Direct Deposit (complete paper form or enroll via DuckWeb)

Department Name

with Paperless Earnings Statement Option

Department Org

Pick-up check at Payroll Office

Earnings Statement Org

(if other than hiring dept)

Authorization

Email Address

Payroll Administrator’s Name (Printed)

Phone Number

Date Signed

Payroll Administrator’s Signature

Business Affairs EIF 30 Jan 2012

University Of Oregon Employee Information Form

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