Fillable AuthorizationForPayrollDeductionTravel909 Authorization for Payroll Deduction - Travel 9-09

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AuthorizationForPayrollDeductionTravel909 Authorization for Payroll Deduction - Travel 9-09

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U.S.A. forms for Southwest Tennessee Community College

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Revised September 2009
Authorization for Payroll Deduction - Travel
Print Full Name ____________________________________________________
Banner ID Number _________________________________________________
Department _______________________________________________________
Title _____________________________________________________________
Campus __________________________________________________________
Amount for Advance $_____________ Date_________ Check No.________
I hereby acknowledge that my acceptance of this travel advance constitutes a debt
to Southwest Tennessee Community College. I agree that upon termination of my
employment or change in travel status, I will reimburse the Tennessee Board of
Regents for any amount of this advance still outstanding. I further agree that any
non-liquidated portion of such advance may be deducted from any unpaid salary
or wages hereafter earned by me or any other monies which may be owed to me
by the Tennessee Board of Regents.
SIGNATURE ______________________________ DATE _______________
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AuthorizationForPayrollDeductionTravel909 Authorization for Payroll Deduction - Travel 9-09

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Completed 14 December 2019

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