Alabama A&M University Escrow Authorization Form
Office of Human Resources Rev. June 2015
SALARY ESCROW ELECTION
(For all 9 month employees)
(Must be elected in the month of August by the 15
th
of the month)
Date: Name:___________________________________________
A-Number: _______________________________________
I hereby elect to have my 9-month’s salary paid to me in 12 payments.
Employee’s Signature Date
Please be advised that the escrow plan cannot be changed or canceled until August
of the following year. Failure to notify the Office of Human Resources by August
15
th
of following year will constitute your continued participation into escrow.
NOTE: When electing the escrow plan, please be advised that you will not receive
your first payroll check until September 30. You will not receive a payroll check on
August 30.
SALARY ESCROW TERMINATION
(Must be terminated in the month of August by the 15
th
of the month. )
I hereby elect to cease having my 9-month’s salary paid to me in 12 payments.
Beginning with my September earnings, I request to receive my 9-month’s pay in 9
payments.
Employee’s Signature Date
This form should be submitted to the Office of Human Resources, 4101 Meridian
Street. If you have any questions regarding the first payment, please contact the
Payroll Department.
Alabama Agricultural and Mechanical University
Office of Human Resources
Mailing Address: Human Resources, Alabama A&M University, Normal, AL 35762
Phone: 256.372.5835 Fax: 256.372.5881
