The Research Foundation of State University of New York
CHANGE/EXTENSION/TERMINATION FORM
(Upon completion of this form, please return it to Office of Human Resources, 216 Bray Hall)
PROJECT DIRECTOR COM PLETES CURRENT INFORM ATION ABOUT EM PLOYEE
EMPLOYEES LAST NAME
FIRST NAME
TITLE
CURRENT SALARY
END DATE
% OF FTE
STATUS
____Employee - SUNY FT Undergrad
____Employee - SUNY FT Grad
____Employee - Regular
____Employee - Summer
SALARY (actual earnings)
_____ Annual $_______________
_____ Biweekly $________________
_____
Hourly $________________
approximate hours per week _________
_____Summer $_________________
PROJECT#
AWARD#
TASK#
LD%
PROJECT DIRECTOR COMPLETES THIS SECTION WITH ANY CHANGES
NAME
CHANGE
NEW
ADDR
ESS
NEW TITLE
SALARY EXTENSION END DATE
STATUS
____ Employee - SUNY FT Undergrad
____ Employee - SUNY FT Grad
____ Employee - Regular
____ Employee - Summer
RESIGNATION/TERMINATION
DATE (last day of work)
SALARY (actual earnings)
____Annual $____________
____Biweekly $____________
____ Hourly $____________
____ Summer $____________
PROJECT#
AWARD#
TASK#
LD%
REASON FOR RESIGNATION/TERMINATION
FORWARDING ADDRESS
DATE
________________________________________________________________
PROJECT DIRECTOR APPROVAL/Signature
(required for all)
____________________________________________________________
DEPT CHAIR/DIRECTOR APPROVAL/Signature Date
REQUIRED FOR ALL PI & CO PI APPOINTMENTS
(for departments that require, see reverse side for listing)
ADDITIONAL APPROVALS
_________________________________________________________________
OFFICE OF RESEARCH PROGRAMS/Signature
DATE
_______________________________________________________________
OPERATIONS MANAGER or DESIGNEE
DATE
TUITION Source____________
Yes No
SPRING 20______
FALL 20______
Emp Cat:___Adm___SP___Agy
OFFICE USE ONLY
EMPLOYEE #
DATE REVIEWED REQ SUBMITTED TO HR
I-9 COMPLETED
____Yes ____No DATE I-9 COMPLETED _____________
VISA TYPE
WORK AUTH EXP DATE
____37.5 NONEXEMPT
____37.5 EXEMPT
LETTER/PNR DONE
STUDENT STATUS
CHECKED
START DATE VERIFICATION:
GRAD/ VISA SHARE FILE DONE
E-VERIFY STATUS
AUTHORIZATION
DATE:
CASE VERIFICATION #:
RPA COPY TO BURSAR
DATE INPUT BY LD COPY TO PAYROLL
SPECIAL NOTES/ *include justification for
retroactive PTA change
New % of FTE
*see page 2___________
WORK REGION
**see page 2 __________
SALARY EXTENSION START DATE
*Retroactive changes to PTA require justification below
approximate hours per week ___________
___Dr. ___Mrs. ___Miss ___Ms. ___Mr.
*
For purposes of pay calculation under the requirements of the Fair Labor Standards Act (FLSA) of 1938 as amended, the
Research Foundation (RF) has established a workweek period that extends from Saturday at 12:00 a.m. through Friday at 11:59
p.m. Wit
hin this workweek period, the Research Foundation has established either a 37.5-hour or 40-hour standard workweek
as the basis for full-time employment [1.0 Full Time Equivalent (FTE)]. Part-time employment is calculated on the standard
workweek.
The designation of standard work week is based upon position requirements. Although assigned a specific standard workweek
relative to the core business hours of the college which is 37.5 hours per week, exempt employees are not covered under the
overtime provisions contained within the Fair Labor Standards Act (FLSA). As such, they may be required to work hours outside
of their standard workweek, based upon job responsibilities or business need.
Dept Chair Signature Requirements
Note: NO signatures are required for hourly students
Chemistry Department - Chair signature NOT required (Required for all PI and CO PI Appointments)
Environmental and Forest Biology Department Chair signature NOT required (Required for all PI and CO PI Appointments)
Environmental Resources and Forest Engineering Department - Chair signature NOT required (Required for all PI and CO PI Appointments)
Environmental Studies Department Chair signature NOT required (Required for all PI and CO PI Appointments)
Forest and Natural Resources Management Department Chair signature NOT required (Required for all PI and CO PI Appointments)
Landscape Architecture Department- Chair signature NOT required (Required for all PI and CO PI Appointments)
Paper Science and Engineering Department - Chair signature required
Revised 5.31.18
**WORK REGION DESCRIPTION
1. Great NYS Other than NYC, Long Island and Westchester_________________________
2. International Outside the U.S._________________________________________________
3. Long Island and Westchester Suffolk, Nassau, Westchester Counties_______________________________
4. NYC Manhattan, Brooklyn, Queens, Bronx, Staten Island Boroughs_____________
5. Out of State U.S. Outside of NYS______________________________________________
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