Fillable Payroll Payrate Changeform Employee’s Name

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Payroll Payrate Changeform Employee’s Name

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STUDENT PAYROLL QUICK CHANGE FORM
PAY RATE CHANGES
Requester’s Name _______________________________ Telephone # _______________
Department _______________________________ Hiring Department # _________
Authorized by _______________________________ Date of Request ____________
Form(s) must be completed and forwarded to the Payroll Office. If you need additional space, please complete
additional forms.
Pay Period Start Date ______________
Student Pay Rate Changes can only be processed on the first day of the pay period.
Please note: Retroactive pay rate changes cannot be processed for student employees. The earliest effective
date that Payroll can use is the first day of the current payroll when we receive this form.
Student Employee Empl ID # Record # Old Pay Rate New Pay Rate
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
_________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
__________________________ __________ ______ $____________ $____________
Additional Comments:
Reminder: If students were granted access to University systems specific to employment, supervisors must notify OTS of employment
termination in order to discontinue this access.
Payroll Office
Administration Building Questions? Call the Financial Services help line at 410-704-5599, option 1
7720 York Road, 4
th
Floor
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Payroll Payrate Changeform Employees Name

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Completed 3 November 2019

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