SOCIAL SECURITY NUMBER

Every authorization must have a valid social security number, if employee does not have a Social Security Number then they should apply for a number and submit a copy

 Please complete if known

 Please use employee's legal name as it appears on the Social Security card

 The address (Street, City, & State, Zip Code) must be the employee's current home mailing address and be consistent with the address listed on the employee's W-4 form

 The individual who typed the authorization and knows of the work that is_to be performed

 For the hiring department/contact person

 An employee who has no previous or current work history on Special Payroll

 No break in service, continuing beyond previous end date

 An employee who is currently working at Uconn

 Must have approval from Human Resources for any classified employee who is working at a professional level

 An employee who has a previous work history on Special Payroll

 To make changes or corrections to a current Special Payroll Authorization such as:title, stipend, start or end date, course information and FRS Account

 Beginning of appointment

 End of appointment or coding period

 Employment is paid from the department account

 The amount to be paid from the FRS Account

 Please use the appropriate title; if employee has more than one title please sbumit a separate payroll authorization for each title

 This is the department where the work is being performed.  The five digit number with two letters following (assigned as a department code)

 If the funding is coming from other than the department where the work is being performed, enter the department code from the fund source here

 The University mail address, location of the work being performed

 Please list section number that you would like the checks to go to

 No payment for work performed, established for status of individual for library privileges, etc

 If concurrently employed at another state agency; the agency number and/or name is required

 The 3-digit course number

 The 2-digit section number

 The location of the course being taught

 The 4-letter abbreviation of the department

 The number of credits associated with the course and section

Indicate Y (yes) or N (no) to signify whether or not the employee is the teacher of record (The teacher of record is the Special Payroll Lecturer who is listed in the Registrar's records as the person responsible for the course.)

 Indicate Y (yes) or N (no) to signify whether or not the employee is team teaching

 Indicate which semester for teaching Fa (fall) or Sp (spring)

 Except for Special Payroll Lecturers at the Law School, Graduate Assistants, and Uconn Graduate Students, Special Payroll Lecturers pay AAUP dues

Please circle either P for primary/subsidiary payment or R for regular payment(Primary will automatically produce a subsidiary every two weeks), (regular payment is paid by-weekly in equal amounts with the final payment being closes to the end date of the authorization)

 The percentage of time on Special Payroll for the work to be performed

 The percentage of Graduate Assistantship

 The total dollar amount to be paid for the time period employed

Please circle Y (yes) or N (no)  (and employee who is currently a Uconn Graduate student)

 RETIRED STATE EMPLOYEE

 Please circle Y (yes) or N (no) (An employee who has retired from state service.  A retiree may
 be employed for up to 120 days per calendar year and if teaching has a 12 credit limit per calendar year