Payroll Document Form - Miami University
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1MIAMI UNIVERSITY Payroll Document
for ONE-TIME PAYMENTS/SPECIAL ASSIGNMENTS/CREDIT WORKSHOPS/UNCLASSIFIED HOURLY
(Non-Grant Funded)
Originating Department/Office: _____________________________________________________________ Dept. Code:______
EMPLOYEE
Name: ______________________________________________________________
BANNER +_________________________
Last
First
MI
Home Department _________________________________________________________________________________________
________________________________________________________________________________(____)____________________
Home address
City
State
Home Phone
Yes
No
________________________ U.S.
Citizen:
Email address
NEW EMPLOYEE
Please direct employee to HR or Academic Personnel, Oxford Campus; or the Business
Office on Hamilton or Middletown campus prior to start date
RE-HIRE
If more than one year since last employment, direct as "New Employee"
CURRENT
Requires approval of Supervisors, if payment is initiated by a department other than
This special assignment: Title ____________________________________________________________________
Description/Duties:
Location of work performed:
Position Type:
Banner
蘀 Oxford
蘀 Hourly rate (section A)
Index Number____ _______$________
蘀 Hamilton
蘀 Daily rate
(section A)
Index Number___________$________
蘀 Middletown
蘀 Salary for work performed (section B)
Index Number __________ $________
蘀 Other__________________
蘀 other _________________ (section B)
Labor account code: ______________
Section (A) Daily Rate: $___________ x ___________ days worked: $______________
OR
Hourly Rate:$___________ x __________ hours worked:$_________
(confirm hours worked on an attached time sheet)
for employment dates of _______________ to _________________
Total Salary: $___________
Section (B) 1. Salary $____________ for employment dates of ______________________to__________________
for duties performed as described above.
If paying a credit workshop salary, number of credit hours_______.
Section (B) 2. Other Rate __________________________________________.
Total Salary:
$__________
Requested by: ____________________________________________________________ Date:____________
APPROVAL of Supervisors
APPROVAL of Expenditure
Type Name
Signature
Date
Type Name
Signature
Date
________________________________________________________________________________
Dept. Head/Chair:
:__________________________________________________________________________________
Dean(s)
Admin Officer
__________________________________________________________________________________
Vice President:
(as necessary)
HR/Academic Personnel office use: Position #: ________
Suffix #: ____ Earn code: ________ Work tax:_____
Eclass: _____
Lcat____
Annual Salary: $_________
FTE: _________
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