STUDENT EMPLOYMENT
PAYMENT REQUEST FORM
This form is to be used when a lump sum payment needs to be paid to a student for work performed. The
preferred method is to pay hourly; however, if the job requires a one-time payment and the project is for 30 days
or less, a payment request may be submitted. The project and amount being paid must be approved by the Office
of Student Employment prior to using the HCM system to request the payment. Please contact the Office of
Student Employment at (216) 368-4533 for instructions on how to process this request.
If the student has never held a job on campus, additional paperwork is required before the project begins. Final
approval rests with the Office of Student Employment; therefore, if we do not have this documenation on file, the
request entered into HCM will not be approved. Federal regulations require that this form be processed before
the student begins working and that the student must complete the I-9 Form (Employment Eligibility Verifica-
tion) with the Office of Student Employment within 3 business days of the hire date.
Term in which work is to be done: q Summer 2020 q Fall 2020 q Spring 2021
Project Name & Hours Required to Complete Project:
Projected time frame for project to be completed:
Compensation due employee for work performed under the project: $
WORK TO BE PERFORMED (please be as specific as possible):
Home Department OPR#: Department:
Speed type to be charged:
Supervisor’s Name (please print):
Supervisor’s E-mail: Phone:
Supervisor’s Signature: Date:
Budget Authority Signature:
STUDENT NAME:
STUDENT EMPLOYEE ID:
STUDENT SIGNATURE:
PLEASE RETURN THE COMPLETED FORM TO:
OFFICE OF STUDENT EMPLOYMENT
YOST HALL, ROOM 412
(216) 368-4533
FAX (216) 368-5054
stu-emp@case.edu
