Student Payroll Form printable pdf download

Student Payroll Form

STUDENT PAYROLL FORM

NAME:______________________________

I.D. # ________________________

DEPARTMENT:_______________________

STUDENT BOX # ______________

PLEASE CHECK APPROPRIATE BOX:

( ) FULL TIME UNDERGRADUATE STUDENT

( ) OTHER (PLEASE SPECIFY) __________________________________________

PLEASE CHECK APPROPRIATE BOX FOR THE ACCOUNT # TO BE CHARGED:

( )

19130

COLLEGE WORK STUDY

( )

19120

UNION COLLEGE WORK PROGRAM

( )

_____

DEPARTMENT OR GRANT BUDGET

HOURLY RATE OF PAY

________________ EFFECTIVE DATE_____________

LUMP SUM AMOUNT ____________________ EFFECTIVE DATE_____________

RATE CHANGE FROM ________ TO ________ EFFECTIVE DATE_____________

UPON HIRE, VERIFY IF THE STUDENT HAS WORKED FOR THE COLLEGE IN THE PAST.

IF THIS IS THEIR FIRST COLLEGE EMPLOYMENT, THE STUDENT MUST GO TO HUMAN

RESOURCES TO FILL OUT A W-4, I-9 AND DOL PAYRATE CERTIFICATION FORM

BEFORE THE STUDENT CAN START WORKING. STUDENTS WHO HAVE SUCCESSFULLY

COMPLETED THEIR PAPERWORK WILL RECEIVE A “CLEARED TO START WORK”

CARD FROM HUMAN RESOURCES.

APPROVALS:

_______________________________________

____________________

STUDENT SUPERVISOR

DATE

_______________________________________

____________________

FINANCIAL AID

DATE

Student Payroll Form