Winthrop University - Student Payment Agreement
ATTENTION: Student work assignment dates may only include the current fiscal year! Fiscal year dates are July 1 – June 30. Summer
work assignments may require two Student Payment Agreements (one for each fiscal year) if the work assignment involves time worked
before and after July 1. Submit original to Human Resources (HR), 303 Tillman Hall.
Undergraduate
Student’s Name CWID# Graduate
Timesheet Org#/Department (for timesheet approvals):
Labor expense charged to: Fund: Org Code: Job Title
Brief description of duties
Hourly
Hourly Rate͗
# of hours/week**
(Must encumber at least 1 hour/week. Most student work is subject to FLSA regulations, including minimum wage of $7.25/hr and
overtime. Students may be paid on a salary basis only if the duties are exempt from FLSA regulations; contact HR if you believe this
position to be exempt) **Subject to the 20 hr/wk maximum during school term and 40 hr/wk max covering first full week of May
through third full week of August.
Exempt/Extracurricular (Prior approval from HR required)
Employment Begin Date End Date Amount of payment to Student
I understand my duties and accept this employment, which is subject to approval below. I also understand that I must enter and
submit for approval the hours that I work according to the published time sheet submission deadlines.
Student Signature/Date PRINTED name of supervisor who will approve the timesheet
Department Head Signature/Date Supervisor Signature/Date
W-4 Forms Submit completed W-4 form along with this payment agreement for newly hired students.
For re-hired students, submit a new W-4 form only if the student wants to make a change in withholding status.
I-9/E-Verify *Required for all newly hired students *May be required for re-hired students
(Contact departmental I-9/E-Verify Coordinator immediately after a job offer has been made and accepted. Please refer to the I-9
online inquiry on the web at www.winthrop.edu/hr
for instructions on completing the I-9/E-Verify process.)
Student Payment Agreement forms (including all correct information), W-4 form (if necessary), and verification of completed I-9/E-
Verify process must be submitted to HR by the deadline date listed below to ensure payment to the student by the check issue date.
For Internal Use Only:
Assignment Data: Position # New position? Yes No Reports to #
NBAPOSN PPAIDEN PEAEMPL NBAJOBS PDADEDN Completed/Verified by: Date: . .
This form is not to be used for Graduate Assistants, contact the Graduate School at 323-2204 for more information.
This form is not to be used for Work Study Students, use the Federal Work-Study Student Payment Agreement on the HR website.
Rev. 05/13
# of hours/week**
