Fillable Addition to Payroll (Student) (New Mexico Institute of Mining & Technology)

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Addition to Payroll (Student) (New Mexico Institute of Mining & Technology)

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Country of origin: US
File type: PDF

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Addition to Payroll (Student)
Banner ID
Student's Name
___________________________________________, _________________________________
Current Department Student is Employed by ___
____________________________________
Agree
to
a
one-time payment of _____________________________ for services listed below.
Index____________ Account # ___________ ST _________
Describe service provided in detail; including date of service):
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
______________________________________________ _______________________________________________
Student Signature Date
I certify the above service is complete, true, and correct.
Department Chair/PI Date
I certify the above service is com
plete, true, and correct.
__
_____________________________________________
______________________________________________
Gr
aduate Dean Date
Budget & Analysis/RFD Date
______________________________________________
______________________________________________
Financial Aid Date
V.P. Admin & Finance Date
PP0007
Revised—28th Nov
2017
New Mexico Institute of Mining and
Technology is an Equal Opportunity/
Affirmative Action Institution.
Payroll Use Only:
Entered Stamp
Verified Stamp
(if none.... STOP.... This is the wrong form)
900XXXXXX
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Addition to Payroll (Student) (New Mexico Institute of Mining & Technology)

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Completed 24 August 2020

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