Hourly Paid Set-Up Authorisation Form printable pdf download

UCD HR Hourly Paid Set-Up Authorisation Form

Please complete Section A and B. Sign section B & send to Head of school/unit for authorisation. If you ticked ‘Yes’ to question 2

in Section A you must complete Section E. All forms must be returned to HR Compensation & Benefits, Roebuck Offices, Belfield.

ALL FIELDS ARE MANDATORY - INCOMPLETE FORMS WILL BE RETURNED TO HOS/UNIT.

(A) Hourly Paid Claimant Details (To be completed by claimant)



Gender: M

First Name:

Middle Initial:

Surname:

Title:

Date of Birth:

PPS No:

Nationality:

e-Mail address:

Telephone No:

Contact Address:

Next of Kin Name:

Next of Kin Tel No:

1. Are you required to have a work permit? No  Yes 

If ‘Yes’ please provide a copy of your GNIB (Garda National Immigration Bureau)Card and attach a separate sheet specifying the grounds under

which you are eligible to work in the Republic of Ireland.

2. Have you ever previously worked in the Public Sector? No  Yes 

If ‘Yes’ please complete Section (E)

Changes in public sector pay policy occurring during the period of this employment will be applied to your remuneration as appropriate

3. Do you currently or have you ever been in receipt of payment from UCD? No  Yes 

If ‘Yes’ please specify type of payment(s) and brief description of role:

If ‘Yes’ please specify UCD Personnel / Payroll number:



Hourly

Salary/Wage

Scholarship

Other

If ‘Yes’ you must specify UCD student number:



4. Are you registered as a student for the current academic year? No

Yes

(B) Payment Details (To be completed by claimant)

Pension Related Deduction

Are you a member of a Public Service Pension Scheme, entitled to a benefit under a public service pension scheme or receive a payment or

No  Yes 

allowance in lieu of membership of a public service pension scheme (other than a UCD Pension Scheme)?

If Yes, please complete & return the Pension Related Deduction Declaration Form available for download on

NOTE: You are not eligible to become a member of the University Pension Scheme. However, you may wish to contribute to a Personal Retirement

Savings Account (PRSA). Irish Life is the University's chosen Standard PRSA provider.

Direct Payment Mandate

Please send all my future wage / salary payments directly to my account:

BIC No: (Max 11 Characters)

IBAN No: (Max 34 Characters)

I declare that all particulars stated in Sections A & B are complete and correct

Claimant Signature:

Date:

School/Unit:

Cost Centre / Grant Code:

Description of Work:

Start Date:

End Date:

Position:

Point:

Rate:

Approver 1

Name:

Approver 2 Name:

If Administrator entering on ESS on behalf of claimant, please specify administrator (Note: Administrator can also be Approver 1)

Administrator Name:

Signed (HOS/Unit):

Date:

Name

(BLOCKS):

Tel Ext:

(D) Processing (HR & Payroll Use Only)

Input & Checked HR

Signed:

Date:

Input & Checked Payroll Signed:

Date:

Hourly Paid Set-Up Authorisation Form

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