Fillable Welcome to Saint Marys Program for Advanced College (Saint Mary's University of Minnesota)

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Welcome to Saint Marys Program for Advanced College (Saint Mary's University of Minnesota)

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Welcome to Saint Mary’s Program for Advanced College Credit!
The following payroll forms need to be completed and returned to Saint Mary’s
before students can be enrolled in your course sections.
1. Completed Employee Record. This form provides the basic information
about you. Please complete all appropriate information.
2. Completed Employee Direct Deposit Authorization. This form gives us
the information to deposit your PACC stipend. It is mandatory for all
employees. Please provide your email address so that a payroll voucher
can be emailed to you to alert you of your deposit.
3. Completed W-4 form, Employee Withholding Allowance Certificate.
This is how you will indicate the number of allowances you wish to claim
on each payroll for both Federal and State withholdings.
4. Completed Employment Eligibility Verification, Form I-9. This provides
Saint Mary’s with your employment eligibility status. You need to
complete Section 1. You are also required to provide us with copies of the
acceptable documentation listed on the back of the form. The most
common forms of ID are usually a copy of your driver’s license and a copy
of your Social Security Card.
If you have any questions, please contact by phone at (507) 457-8720 or by
email at dsharroc@smumn.edu. Thank you in advance to your attention to these
forms.
Sincerely,
Denise Sharrock-Mueller
Director, PACC
(emprec050415.rtf)
Employee Record
Name Title
(Last name, first name, middle intial) (Ms, Mr, Dr, etc.)
Address
City, State, Zipcode
Phone
Social Security Number
Date of Birth
/ / E-Mail Address
Sex: M F
(please circle one) Marital Status: M S (please circle one)
Race/Ethnic Background
(optional, please check one)
____Asian, Asian American or Pacific Islander ____African American /Black
____Hispanic/Mexican American/Central American ____American Indian or Alaskan Native
____Other Latino ____Other
____Puerto Rican ____White, Non-Hispanic
Religion (optional, please check one)
____Catholic ____Baptist ____Muslim ____Other___________
____Orthodox Christian ____Episcopalian/Anglican ____Buddhist _________________
____Lutheran ____Presbyterian ____Hindu
____Methodist ____Jewish ____None
Degree(s) Earned/Field of Study/Degree Granting Institution
Spouse’s Name
Spouse’s DOB / /
(optional)
In emergency notify: Name
Address
City, State, Zipcode
Phone
SMU Department/Program
Position/Title/Rank
Start Date
Today’s Date
DirectDepositStaff.doc
Employee Direct Deposit Authorization Form
Direct deposit of payroll is mandatory for employees of Saint Mary’s University. Instead of a check you will
receive either an e-mail voucher or view your information on a secure website. Your money will be deposited
into your account no later than the day of payroll (in most instances, it will be in your account the day before
payroll). Your payment can be directed to multiple banks and/or multiple accounts.
Please complete and return this form to the Business Office. Contact Paul Wildenborg at (507) 457-1442 or
x1442 if you have any questions.
If using a checking account, attach a voided check or check copy here.
If using a savings account, contact your bank for the routing number and account number.
Do not use the number on the bottom of a deposit slip, that number is not the routing number and will
not work.
I authorize Saint Mary’s University of Minnesota and the financial institution listed below to initiate
electronic credit entries, and if necessary, debit and adjustments for any credit entries in error to my account.
This authority will remain in effect until I have canceled it in writing.
I would like to receive my voucher via e-mail at
(e-mail address)
___ Checking Account ___ Savings Account
FINANCIAL INSTITUTION NAME (PLEASE PRINT)
BRANCH SOCIAL SECURITY NUMBER
CITY STATE SIGNATURE
PHONE NUMBER OF FINANCIAL INSTITUTION DATE
:
:
TRANSIT ROUTING NUMBER ACCOUNT NUMBER INFORMATION
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Welcome to Saint Marys Program for Advanced College (Saint Mary's University of Minnesota)

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Completed 26 August 2020

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