Revised 4/15/2013
Date: __________
I wish to be paid by the pay plan option indicated below:
______ OPTION 1 Total academic/contract year salary to be paid in twenty
(20) consecutive bi-weekly payments.
______ OPTION 2 Total academic/contract year salary to be paid over a
twelve (12) month period which will be paid in twenty-six (26)
consecutive bi-weekly payments.
I understand that my election of the above option is irrevocable for this current
academic/contract year. I understand further that this election will be
automatically carried forward to each new academic/contract year that I am
employed by the University, unless I submit a change in my pay option election
prior to July 15
for each new academic/ contract year that the change is to become
Employee’s Signature _______________________
Name (Print) ________________________
Department ________________________
Academic/Contract Year ________________________
Date received in HR __________________
Print Form