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As417 Louisiana State University

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Louisiana State University
Office of Accounting Services
Payroll
204 Thomas Boyd Hall
TURNAROUND DOCUMENT (PER17) AS417
Nature of Action
Appointment Change in Source of Funds (CSF) Change in Percent Effort
Change in Rate of Pay Extra Earnings Separation
Employee (Last, First, MI)
LSU ID
Type of Employee Student Contingent Graduate Assistant
Pay Basis Academic Year Fiscal Year Summer Session
Transfer Effective Date Transfer End Date
For Student & Contingent Employees:
Account #
Object
Code
Current
Hourly Rate
Proposed
Hourly Rate
Rate of Pay Justification *
* If the Proposed Hourly Rate exceeds the maximum hourly rate stated in PS-33, justify and route through Office of Student Aid & Scholarships.
For Graduate Assistants:
Rev 07/07
Account #
Object
Code
Current
Annual Rate
Proposed
Annual Rate
Extra Earnings:
Account #
Object
Code
Hourly
Rate
Total Authorized Will Timesheets be submitted?
1080 Yes No
1080 Yes No
Justification (required for sponsored agreements) ____________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Approved by
________________________________________ ____________________________________ _____________________
Department Printed Name Date
________________________________________ ____________________________________ _____________________
Dean or Other Authority Printed Name Date
________________________________________ ____________________________________ _____________________
Graduate School (for GA’s) Printed Name Date
________________________________________ ____________________________________ _____________________
Student Aid & Scholarships (for Students) Printed Name Date
________________________________________ ____________________________________ _____________________
SPA Printed Name Date
Print Form
Rev 07/07
AS417, “Turnaround Document (PER17)” Instructions
Nature of Action must be completed. Check all that apply.
Employee Name, LSUID, Type of Employee and Pay Basis must be completed.
Transfer Effective Date is the begin date for work performed on the new account or, in the case of an
appointment, the first day worked.
Transfer End Date is the final date for work performed on the new account, or in the case of a termination, the
last day worked.
Note: The dates of the PER 17 must cover the entire period of the form it replaces
. If the change is for a
shorter period of time, two forms should be completed. There cannot be a break in service.
For a Student or Contingent employee, the Current and Proposed Account, Object Code and Hourly Rate
must be completed. Do not enter the amount to be transferred. The transfer amount will be calculated using the
information provided on the PER 17. For a Graduate Assistant the Current and Proposed Account, Object
Code and Annual Rate must be completed. Do not enter the amount to be transferred. The transfer amount will
be calculated using the information provided on the PER 17. The current information must include all
accounts to which the employee is currently charged.
The Extra Earnings section should be completed only in cases in which the department does not have access to
the Add Comp system. Departments should request access to the Add Comp system through Financial Systems
Services (FSS).
A Justification for retroactive transactions on sponsored agreements must be provided. The PER 17 will be
returned to the department if this section is not completed.
All necessary approvals must be obtained before routing the PER 17 to Payroll. For students paid with Work
Study or Chancellor’s Aid funds, or in cases where the hourly rate exceeds the maximum allowed on PS-33,
Student Aid approval is required. For GA’s, Graduate School approval is necessary. HRM must approve the
PER17 for contingent employees. Payroll will route to Sponsored Program Accounting for approval on sponsored
agreements.
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As417 Louisiana State University

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Completed 3 March 2020

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