Fillable Dual Employment (State University of New York College of Agriculture and Technology at Cobleskill)

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Dual Employment (State University of New York College of Agriculture and Technology at Cobleskill)

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U.S.A. forms for State University of New York College of Agriculture and Technology at Cobleskill

BROWSE STATE UNIVERSITY OF NEW YORK COLLEGE OF AGRICULTURE AND TECHNOLOGY AT COBLESKILL FORMS

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STATE OF NEW YORK
OFFICE OF THE STATE COMPTROLLER
BUREAU OF STATE PAYROLL SERVICES
DUAL EMPLOYMENT/EXTRA SERVICE APPROVAL FORM
REQUEST FOR APPROVAL TO SERVE WITH ANOTHER STATE AGENCY
SEND APPROVALS TO:
Offi ce of the State Comptroller
Bureau of State Payroll Services
TO BE COMPLETED BY EMPLOYEE
PRESENT EMPLOYMENT:
Name .................................................................................... Agency (where employed) ...........................................................
Title ..................................................................................... Dept. ID .......................................................................................
Email Address ...................................................................... Last 4 Digits of Social Security Number ......................................
ADDITIONAL EMPLOYMENT REQUEST:
I request approval to render additional service to the......................................................................................................................
at ............................................................... , for the period from .......................................through .................................................
for the purpose of ............................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
I do not render additional service in any other agency.
I render additional service in another agency. The name of that agency is
......................................................................................... Dept. ID ....................................
This requested additional service will not interfere with my regular duties.
Date ...................................................................... Signature ............................................................................................
ACTION BY HEAD OF DEPARTMENT OR AGENCY WHERE REGULARLY EMPLOYED
* Approved

Disapproved (Do not forward to Offi ce of the State Comptroller)
Approved through ..........................................................

Approved with the following limitations: ....................................................................................................................................
.........................................................................................................................................................................................................
This additional service will not interfere with the
performance of the employee’s regular duties.
Date ................................................................... By ................................................................................
* ALL APPROVALS WITHOUT A LIMITING DATE WILL EXPIRE
CLOSE OF BUSINESS ON MARCH 31st OF THE FISCAL YEAR.
A Signed Original of this Form Must Be Forwarded to the Bureau of State Payroll Services Before Payments Can Be Processed.
AC 1588 (Rev. 4/09)
(Name of Agency) (Dept. ID)
(Brief Description of Work to be Performed)
(Location of Employment)
Name of Agency Department Head
(Signature & Title of Authorized Designee)
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Dual Employment (State University of New York College of Agriculture and Technology at Cobleskill)

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Completed 26 July 2020

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