Authorization for Hire
Employee Name:
(As it appears on your Social Security Card.
Employee Social Security Number:
W#: _________________________
Sex: Male Female
Birthdate:
Highest Degree:
Check One: Student Non- Student
Have you completed an I-9 (good for 3 yrs) : Yes No
Address: (paycheck address)
(W2 address if different)
Telephone Number: ( ) _____ _____________
E-Mail Address: ___________________________
To be completed by Professor or Supervisor
Rate of Pay: Hours per week:
Account to be paid from:
Will this employee be working in a labor in the field? _________
Start Date: End Date:
Signature:
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signature
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