Fillable Form 1.: guidelines on page 10. Keep both (Arizona State University)

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Office of Human Resources | New hire packet – page 1
3/26/20
Tax resources
Federal
Internal Revenue Service
Taxpayer Assistance 800-829-1040
State
Arizona Department of Revenue
Taxpayer Assistance 800-843-7196
ASU HR and Payroll Offices
cannot offer tax advice.
1.
Complete all requested data on the Personal data form. See page 2.
2.
U.S. citizens and permanent residents: Read, sign and date
the Public employee or officer loyalty oath on page 3.
3.
Graduate assistants and associates and student workers:
4.
Read the Tax withholding for student wages section on page 4
and read the Graduate and undergraduate student employment
guidelines on page 10. Keep both documents for your records.
5.
Read, sign and date the Conditions of employment form on
page 5.
6.
Follow the provided Form I-9 instructions on page 6 to complete forms.
7.
Review New Health Insurance Marketplace coverage options on page 8.
After your first day
Visit My ASU > Faculty or Staff > My Employment > Payroll
Complete your state of Arizona (A-4) and Federal (W-4) forms.
Payroll >Tax Information > A-4 Tax Information or W-4 Tax
Information.
For direct deposit of your paycheck, complete the direct deposit information
online: Payroll > Direct Deposit.
To receive a paper paycheck, do nothing and your department will
receive your check each pay period.
Visit My ASU > Faculty or Staff > Employment > Personal to update:
At this time, call the employee service center at 1-855-278-5081 or submit a
case online for guidance on how to complete your Form I-9 and submission
of this packet.
New hire packet
Important Form I-9 information
Complete the Form I-9 within three
business days of your date of hire.
Follow instructions provided in this
packet.
Please read the List of Acceptable
Documents on page 3 of the
federal I-9 form.
You must show one original
document from List A, or two
original documents, one from List B
and one from List C.
Note: You cannot use two
documents from the same list to
meet U.S. Department of
Homeland Security employment
eligibility verification. Expired and
photocopies of documents are
not acceptable per federal law.
International employees on
an F-1, J-1 or H-1B visa status
must present their passport,
Form I-94, and I-20 or DS-
2019 or I-797 to determine
sponsorship and length of
employment eligibility.
Before your first day
Your new employee to-do list
Office of Human Resources | New hire packet - page 2
3/26/20
2
Personal data form
Complete all forms in blue or black ink.
ASU ID number
New employee
Current employee
Rehire
Student worker
Yes
No
Please enter your name as it appears on your Social Security card or visa document
Last name
First name
Middle name
Home address
Apt, suite, unit
City
State Zip code
Mailing address, if different from
home address.
Apt, suite, unit
City
State Zip code
Phone numbers including area code
Home
Cell
ASU
Email address
Personal
ASU
Personal information
Social security number, if card has been issued.
Date of birth
Gender
Female
Male
Emergency contact
Name
Relationship Phone number
The information stated above is correct and accurate to the best of my ability. I understand all future changes must be
made through My ASU as soon as possible.
Employee signature-Handwritten Date
click to sign
signature
click to edit
Office of Human Resources | New hire packet – page 3
3/26/20
Public employee or officer loyalty
Arizona State University is required by state law to reproduce the following statute and obtain
each employee’s signature in paragraph E. Sec. 38-231 Arizona Revised Statutes.
38-231. Officers and employees required to take loyalty oath; form; classification; definition
A.
In order to ensure the statewide application of this section on a uniform basis, each board, commission,
agency and independent office of this state, and of any of its political subdivisions, and of any county, city,
town, municipal corporation, school district and public educational institution, shall completely reproduce this
section so that the form of written oath or affirmation required in this section contains all of the provisions of
this section for use by all officers and employees of all boards, commissions, agencies and independent
offices.
B.
Any officer or employee who fails to take and subscribe to the oath or affirmation provided by this section
within the time limits prescribed by this section is not entitled to any compensation until the officer or employee
does take and subscribe to the form of oath or affirmation prescribed by this section.
C.
Any officer or employee having taken the form of oath or affirmation prescribed by this section, and
knowingly at the time of subscribing to the oath or affirmation, or at any time thereafter during the officer’s or
employee’s term of office or employment, does commit or aid in the commission of any act to overthrow by
force, violence or terrorism as defined in section 13-2301 the government of this state or of any of its political
subdivisions, or advocates the overthrow by force, violence or terrorism as defined in section 13-2301of
the government of this state or any of its political subdivisions, is guilty of a class 4felony and, on conviction
under this section, the officer or employee is deemed discharged from the office or employment and is not
entitled to any additional compensation or any other emoluments or benefits which may have been
incident or appurtenant to the office or employment.
D.
Any of the persons referred to in article XVIII, section 10, Constitution of Arizona, as amended, relating to
the employment of aliens, are exempted from any compliance with this section.
E.
In addition to any other form of oath or affirmation specifically provided bylaw for an officer or employee,
before any officer or employee enters upon the duties of the office or employment, the officer of employee shall
take and subscribe the following oath or affirmation:
F.
For the purposes of this section, “officer or employee” means any person elected, appointed or employed,
either on a part-time or full-time basis, by this state or any of its political subdivisions or any county, city, town,
municipal corporation, school district, public educational institution or any board, commission or agency of any
county, city, town, municipal corporation, school district or public educational institution.
Signature of officer or employee
Date
State of Arizona, County of Maricopa I,
Type or print name
do solemnly swear or affirm that I will support the Constitution of the United States and the Constitution and laws of
the State of Arizona, that I will bear true faith and allegiance to the same and defend them against enemies,
foreign and domestic, and that I will faithfully and impartially discharge the duties of the of _ _ _
Name of office
according to the best of my ability, so help me God or so I do affirm.
click to sign
signature
click to edit
Office of Human Resources | New hire packet – page 4
3/26/20
Tax withholding on student wages
Wages paid to a student employee through the payroll system are subject to the following
withholding taxes: Federal income tax, state income tax and FICA - social security and Medicare.
The withholding of federal and state taxes is dependent upon the student's biweekly gross income and how
the student files their W-4 and A-4 forms. A student may seek advice from the IRS regarding how to file their
W-4 Form or advice from the ADOR regarding how to file their A-4 Form.
Internal Revenue Service toll-free number, 800-829-1040
Arizona Department of Revenue toll-free number, 800-843-7196
The number of credit hours a student is enrolled for at the end of the drop or add period
determines whether or not FICA tax is withheld. To be exempt from FICA tax, a student must be
enrolled at least half time:
Fall or spring term — Session A,
session B or session C
Undergraduate
Graduate
Graduate assistant
Six or more hours
Five or more hours
Three or more hours
Summer term — Session A,
session B or session C
Undergraduate
Graduate
Graduate assistant
Two or more hours
Two or more hours
One or more hours
If a break between classes is more than five weeks, FICA exemption does not apply.
Note: For enrollment verification purposes, graduate assistant is a generic term used in the table
above that includes graduate assistants, graduate research assistants or associates and
graduate teaching assistants or associates.
F-1 and J-1 Status nonresident alien student exemption
Non-resident alien student admitted to the United States on an F-1 or J-1visa remain ina FICA tax-
exempt status regardless of the credit hour enrollment requirement until they have passed the
substantial presence test, e.g. been present in the U.S. more than four calendar years.
More information
Substantial presence test: IRS Publication 519: irs.gov/pub/irs-pdf/p519.pdf
ASU Foreign Visitor Tax Guide: cfo.asu.edu/foreign-visitor-taxguide
Office of Human Resources | New hire packet – page 5
3/26/20
Conditions of employment form
Required of new hire
Instructions
1.
Required of all employees prior to employment.
2.
Please read the following statements and sign.
3.
The signed form will be placed in your personnel file.
False statements
In applying for positions at ASU, I understand that any false statement, misrepresentations or
omission of requested information will disqualify me for employment consideration or cause my
subsequent dismissal.
Drug-free workplace requirements
It is prohibited to unlawfully manufacture, sell, possess, distribute, dispense or use controlled
substances in the workplace.
As a condition of employment, each staff member must agree to the following terms:
1.
Abide by terms of policy SPP 315 - Drug Free Workplace Requirements.
2.
Notify the ASU General Counsel’s Office of any criminal drug conviction for a violation occurring in the
workplace within five days after such conviction.
Commercial Driver’s License
Any employee who drives or repairs commercial vehicles must have a Commercial Driver’s License and is
subject to alcohol and drug testing in accordance with the Employee Testing Act of 1991 and the U.S.
Department of Transportation/Alcohol and Drug Testing Compliance regulations: 49CFRpart382.102.
Proof of citizenship
I understand that I will be required to show proof of citizenship or the legal right to work in the United States
within three working days of the hire date.
Authorization
I authorize ASU to investigate all statements on my application materials, including contacting my professional
references. I realize that I have the right to make a written request within six months to receive information
about the nature and scope of this investigation.
Overtime
The overtime policy of ASU for non-exempt employees is to provide, at its discretion, either one and
one-half hours compensatory time off or additional pay at one and one-half times the regular rate of pay for each
hour worked in excess of 40 hours per week - exclusive of flexible work schedules/work weeks.
The compensatory time off may be preserved, used or cashed out as provided by the Fair Labor Standards
Act. I understand and agree to accept this overtime policy as a condition of employment as non-exempt staff
with ASU. In the event I am exempt staff at the time of initial hire and subsequently reclassified to non-exempt
staff, I understand and agree to accept this overtime policy as a condition of my continued employment. My
decision to accept this overtime policy is made knowingly, voluntarily and without coercion by ASU.
I have read and understand the above statements. I verify that the information I have submitted on this form is
accurate and complete.
Signature ASU ID number Date signed
Arizona State University is an equal opportunity and affirmative action employer.
click to sign
signature
click to edit
Office of Human Resources | New hire packet – page 6
3/26/20
Form I-9 instructions
Per federal regulation, ASU must document that each new employee, citizen and non-citizen,
hired after Nov. 6, 1986, is authorized to work in the U.S.
If you are outside of Arizona, use this information to process your Form I-9:
asu.edu/hr/documents/I9notaryinstructions.pdf
Hires in the state of Arizona, use these steps to process your Form I-9:
Step 1: Log onto Equifax employee site:
https://secure.i9.talx.com/FormI9/Section1/LoginCaptcha.ascx?Employer=13789
Step 2: Complete section 1 of Form I-9:
Start date: Enter your first day of work as listed on your offer letter.
o Location code: Select the location where you will present your original documentation.
o Citizenship status: You must select the correct status based on your situation.
o See Form I-9 Instructions for details: uscis.gov/sites/default/files/files/form/i-9instr.pdf
o Print or email the confirmation and collect your original documents.
Step 3: At this time, call the employee service center at 1-855-278-5081 or submit a case online
for guidance on how to complete your Form I-9 and submission of this packet.
Office of Human Resources | New hire packet – page 8
3/26/20
New Health Insurance
Marketplace Coverage Options
and Your Health Coverage
General information
When key parts of the Affordable Care Act take effect in 2014, there will be a new way to buy health
insurance: through the health insurance marketplace. To assist you as you evaluate options for you
and your family, this notice provides some basic information about the new marketplaces and
employment-based health coverage offered by your employer.
What is the health insurance marketplace?
The marketplace is designed to help you find health insurance that meets your needs and fits your
budget. The marketplace is a resource to find and compare private health insurance options. You can
enroll for health insurance coverage through the Marketplace during an enrollment period that begins in
October 2013. Coverage can begin as early as January 1, 2014.
Can I save money on my health insurance premiums in the marketplace?
You may qualify to save money and lower your monthly premium, but only if your employer does not offer
coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're
eligible for depends on your household income.
Does employer health coverage affect eligibility for premium savings through the
marketplace?
Yes. If you have an offer of health coverage from your employer that meets certain standards, you will
not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's
health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a
reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not
offer coverage that meets certain standards. If the cost of a plan from your employer that would cover
you and not any other members of your family is more than 9.5% of your household income for that
year, or if the coverage your employer provides does not meet the "minimum value" standard set by
the Affordable Care Act, you may be eligible for a tax credit.
1
Note: If you purchase a health plan through the marketplace instead of accepting health coverage
offered by your employer, then you will lose any employer contribution to the State of Arizona Benefit
Options Plan. Also, this employer contribution - as well as your employee contribution to State of
Arizona Benefit Options Plan - is often excluded from income for Federal and State income tax
purposes. Your payments for coverage through the marketplace are made on an after-tax basis.
Future enrollment in the State of Arizona Benefit options plan will be limited to open enrollment,
which typically happens in the fall.
1
An Employer-sponsored health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit
costs covered by the plan is no less than 60% of such costs. Section 36B(c)(2)(C)(ii) of the Internal Revenue Code of
1986.
_
Health Insurance Marketplace coverage Expires May 31,
2020
Office of Human Resources | New hire packet – page 9
3/26/20
How can I get more information?
For more information about your coverage offered by your employer, please check your summary
plan description or use the ASU Office of Human Resources Employee Service Center contact
information included in the employer information chart.
The marketplace can help you evaluate your coverage options, including your eligibility for
coverage through the marketplace and its cost. Please visit healthcare.gov for more
information, including an online application for health insurance coverage and a Health
Insurance Marketplace in your area.
Information about health coverage offered by your employer
If you decide to complete an application for coverage in the marketplace, you will be asked to provide
the information included in the chart below. This employer information is numbered to
correspond to the marketplace application.
Employer Information
3. Employer Name
Arizona State University
4. Employer Identification Number
86-0196696
5. Employer Address
P.O. Box 871304
6. Employer Phone Number
855-278-5081
7. City
Tempe
8. State
AZ
9. Zip Code
85287-1304
10. Who can we contact about employee health coverage at this job?
Human Resources Employee Service Center
11. Phone Number if different from above.
12. E-mail Address
HRESC@asu.edu
Here is some basic information about health covered offered by this employer:
ï
As your employer, we offer a health plan to some employees and dependents. Eligible employees
and dependents are:
Defined in the EPO, PPO and HSA plan descriptions under Article 3 Eligibility and Participation.
Visit Benefit Options benefitoptions.az.gov for details.
ï
This coverage provided meets the minimum value standard, and the cost of this coverage to you
is intended to be affordable, based on employee wages.
If you decide to shop for coverage in the marketplace, healthcare.gov will guide you through the
process. The employer information you can enter online will help you determine if you can receive a subsidy (n the
form of a tax credit to lower your monthly premiums for coverage purchased through the marketplace.
Office of Human Resources | New hire packet – page 10
3/26/20
Graduate and undergraduate student employment guidelines
The primary focus for any ASU student is their education. ASU recognizes that some
students may need to supplement their income with on-campus work in order to help fund
their education. To ensure the student’s education and training are not compromised by
commitments to additional employment, the following ASU employment guidelines must
be followed.
For graduate students
ï
Students holding assistantships or graduate intern appointments during the academic year may
work a maximum of 0.50 FTE. During the summer, these students may work a maximum of 1.00 FTE.
ï
Students holding hourly student worker positions during the academic year may work a maximum of
25 hours per week. During the summer, these students may work up to a maximum of 40 hours per week.
ï
All positions combined including stipend-paid positions cannot exceed 0.625 FTE or 25 hours per
week for the first 12 months of employment or from October to October in subsequent years of employment.
Some important areas to think about
ï
If you average more than 0.625 FTE or 25 hours per week, your employment will be terminated from all
ASU jobs.
ï
If you are terminated for exceeding the 0.625 FTE or 25-hour weekly maximum, you are not eligible for rehire
at ASU in a student worker, faculty associate or graduate student position for at least 26 weeks.
For undergraduate students
ï
Student employees are limited to a rolling average of 25 hours per week per year.
ï
Students can work up to 100 percent in the summer, provided they do not exceed an average of 25 hours
per week for the first 12 months of ASU employment or from October to October in subsequent years of
employment.
ï
This 25-hour average maximum applies to the combined total of all jobs, including hours associated with
stipend-based compensation.
Some important areas to think about
ï
If you average more than 25 hours per week, you will be terminated from all ASU jobs.
ï
If you are terminated for exceeding the 25-hour weekly maximum, you are not eligible forrehire at ASUin
an undergraduate or graduate student position for at least 26 weeks.
Please help us minimize any disruption to your education, employment experience and, if applicable, your
graduate assistantship or graduate intern appointment by being mindful of your total ASU employment hours.
If you have questions about your hours, contact your supervisor or the hiring manager for your department.
Effective date of student employment guidelines: May 2014.
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