TO: PAYROLL DEPARTMENT Date: _________________
FROM (department name): ___________________________________
NAME OF CHAIRPERSON: _____________________________ Signature: ______________________
SUBJECT: SUBSTITUTE TEACHER PAY
**Prepared by (first and last name): ______________________________ Ext: _______________
1.
Services Performed by (Name): _________________________________ PS Position #: _______________
Employee ID #: ________________________ Record #: __________________
Social Security Number: _____________________
Substitute for ______________________________ Dept. ______________________
The substitute is employed , was employed , never employed at CSULA.
2. REASON FOR REQUESTING SUBSTITUTE TEACHER:
3. Position number to be charged: GFND ______ _______
Unit Class Hourly Rate: $__________
Chart Field: ________ ________ ________ ________
Account Fund Dept ID Program Total Payment: $__________
4.
5. DESCRIPTION OF SERVICES:
Dates of Substitution Course No. Total Hours Taught Classification of Hours (Lecture or Activity/Lab)
**Retirement System: PERS STRS Other:_______________
**Retired Annuitant: yes no **FERP: yes no
**Funding Source State Contract: yes no
6. Approved by: ________________________________ ______________ ____________
(Authorized Signature) Date Ext.
**Mandatory
0907SubsituteTeacherPay.xls
California State University, Los Angeles
Payment Authorization for Substitute Teacher Pay
MEMORANDUM
SERVICE DATES AND HOURS WORKED - INDICATE THE DATE(s) AND THE NUMBER OF HOURS THE
REGULAR FACULTY MEMBER WILL REPORT ON HIS/HER ABSENCE REQUEST FORM (F634) FOR THE
PAY PERIOD IN WHICH THE ABSENCE OCCURRED:
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PROCEDURES:
For Substitute Teacher Pay, college resource managers or designee should ensure
o
All Substitute Teacher Pay forms be completed and signed by the Department Chair and Dean.
o
PS position number that has already been entered is reflective of the appropriate class code, reporting unit and chartfield prior to submittal.
o
List each day substituted on a separate line.
o
Show the total amount of time worked per day (record in hours).
o
Time must be submitted in increments of ½ hours (not less).
o
Indicate the time worked as Lecture hours or Activity / Lab hours.
o
A substitute teacher that has never worked for CSULA or has been away for more than one year must come to HRM for I-9 clearance.
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