Fillable Pm 65 Pr3 (Louisiana State University)

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Pm 65 Pr3 (Louisiana State University)

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Lou
isiana State University
Office of Accounting Services
Payroll
204 Thomas Boyd Hall
Request for Payroll Deduction Slot
I, Sheantel Baker, Director, Payroll, on behalf of the employees of Louisiana State
University, hereby request favorable consideration of a payroll deduction
application submitted by:
Vendor Name:
Address:
Tax ID#:
I further certify that this request does not represent a duplication of deductions
currently available in the payroll system and that a review and/or survey conducted
by (_________________) has indicated a need for this particular deduction; and
that the above-named vendor application has provided evidence of having met
and/or exceeded all requirements of R.S. 42:455.
Louisiana State University
by ____________________________
Sheantel Baker
Director, Payroll
DATE
LSUPR 3
LSU-PR3
insert campus name
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Completed 23 July 2020

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