STATE UNIVERSITY OF NEW YORK OFFICE OF EMPLOYEE RELATIONS AND PERSONNEL SEND APPROVALS TO: Office of the State Comptroller Bureau of Payroll Audit DUAL EMPLOYMENT/EXTRA SERVICE APPROVAL FORM REQUEST FOR APPROVAL TO SERVE ANOTHER STATE AGENCY TO BE COMPLETED BY EMPLOYEE PRESENT EMPLOYMENT: Name Agency (where employed) Title B Number ADDITIONAL EMPLOYMENT REQUEST: I request approval to render additional service to the (Name of State agency) (agency code) at for the period from through (location of employment) for the purpose of (brief description of work to be performed) I do not render additional services in any other agency I render additional services in another agency. The name of that agency is.. ACTION BY HEAD OF DEPARTMENT OR AGENCY WHERE REGULARLY EMPLOYED Approved Approved through Disapproved (Do not forward to Office of the State Comptroller) Approved with the following limitations: This additional service will not interfere with the performance of the employee s regular duties. Name of Agency or Department Head Date All approvals without a limiting date will expire close of business on March 31 st of the fiscal year. By (Signature & Title of Authorized Designee) A signed original of this form must be forwarded to the Bureau Of Payroll Audit before payments can be processed.
Instructions for Voucher Completion & Submission Payment(s) cannot be processed if approval and/or voucher(s) are missing or incomplete 1. You will need to print and complete one voucher for each payment you are to receive. (See #2 above). You can submit all the payroll vouchers at one time, if future dates and times are known. Note: (example, if extra service will be performed from 1/26/2008 through 5/18/2008 you may submit all the vouchers for the entire spring semester at one time) this will ensure timely payments. Late payroll vouchers may cause a delay in payment(s). 2. Please print: Name Social Security number. Check (28020 for Faculty/Staff payroll, 28029 for GA/TA payroll) Regular Position Title (i.e. Adjunct Professor, Professor, Staff Assistant, etc.) If known Salary (your regular salary) if known 3. Return all completed forms to Human Resources, Office of Human Resources AD-244 PO Box 6000 Binghamton, NY 13902-6000 If you should have any questions regarding the completion of your extra service paperwork, please contact us at one of the telephone numbers below: 1-607-777-3321 Jonathan Roma 1-607-777-6950 Sharon Woolever Thank you, Binghamton University HR Department
AC873 (Rev 09/08) STATE OF NEW YORK *Name of Employee: *B Number: Agency in which regularly employed: Binghamton University 280... Regular Position Title (if known) Retirement Rate Salary (if known) Item No. Extra Service Position Title TOTAL Date: Employee Signature:
STATE OF NEW YORK *Name of Employee: John Doe *B Number: B123456789 Agency in which regularly employed: Binghamton University 28020 Regular Position Title (if known)_staff Associate Retirement Rate Salary (if known) 32,000 Item No. Extra Service Position Title Staff Associate 5/23/05 6:30 5/24/05 6:30 5/25/05 6:30 8:30 2 8:30 2 8:30 2 TOTAL 6 Date: 5/25/05 Employee Signature: John Doe AC873 (Rev 09/08)
STATE OF NEW YORK *Name of Employee: *B Number: Agency in which regularly employed: Binghamton University 280... Regular Position Title (if known) Retirement Rate Salary (if known) Item No. Extra Service Position Title TOTAL Date: Employee Signature:
AC873 (Rev 09/08) STATE OF NEW YORK *Name of Employee: *B Number: Agency in which regularly employed: Binghamton University 280... Regular Position Title (if known) Retirement Rate Salary (if known) Item No. Extra Service Position Title TOTAL Date: Employee Signature:
Period No. Office of the State Comptroller BUREAU OF STATE PAYROLL SERVICES ADMINISTRATION PAYROLL CALENDAR APRIL 1, 2008 APRIL 30, 2009 LAG APRIL 2008 OCTOBER 2008 26 1 2 3 4 5 1 2 3 4 13 6 7 8 9 10 11 12 5 6 7 8 9 10 11 1 13 14 15 16 17 18 19 12 H 14 15 16 17 18 14 20 21 22 23 24 25 26 19 20 21 22 23 24 25 2 27 28 29 30 26 27 28 29 30 31 15 MAY 2008 NOVEMBER 2008 1 2 3 1 4 5 6 7 8 9 10 2 3 4 5 6 7 8 3 11 12 13 14 15 16 17 9 10 H 12 13 14 15 16 18 19 20 21 22 23 24 16 17 18 19 20 21 22 4 25 H 27 28 29 30 31 23 24 25 26 H 28 29 17 30 JUNE 2008 DECEMBER 2008 1 2 3 4 5 6 7 1 2 3 4 5 6 5 8 9 10 11 12 13 14 7 8 9 10 11 12 13 18 15 16 17 18 19 20 21 14 15 16 17 18 19 20 6 22 23 24 25 26 27 28 21 22 23 24 H 26 27 19 29 30 28 29 30 31 JULY 2008 JANUARY 2009 1 2 3 H 5 H 2 3 7 6 7 8 9 10 11 12 4 5 6 7 8 9 10 20 13 14 15 16 17 18 19 11 12 13 14 15 16 17 8 20 21 22 23 24 25 26 18 H 20 21 22 23 24 21 27 28 29 30 31 25 26 27 28 29 30 31 AUGUST 2008 FEBRUARY 2009 1 2 1 2 3 4 5 6 7 22 9 3 4 5 6 7 8 9 8 9 10 11 12 13 14 10 11 12 13 14 15 16 15 H 17 18 19 20 21 23 10 17 18 19 20 21 22 23 22 23 24 25 26 27 28 24 25 26 27 28 29 30 31 SEPTEMBER 2008 MARCH 2009 Period No. 11 H 2 3 4 5 6 1 2 3 4 5 6 7 24 7 8 9 10 11 12 13 8 9 10 11 12 13 14 12 14 15 16 17 18 19 20 15 16 17 18 19 20 21 25 21 22 23 24 25 26 27 22 23 24 25 26 27 28 28 29 30 29 30 31 Period No. NEW FISCAL YEAR 2009-2010 APRIL 2009 SUN MON TUE WED THU FRI SAT 26 1 2 3 4 5 6 7 8 9 10 11 1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 2 26 27 28 29 30 Payday is the Wednesday two weeks after the ending date of the payroll period. When a payday falls on a holiday, the check will be dated the previous day. = PAYROLL PERIOD ENDING H = HOLIDAY ADMINISTRATION AGENCIES 2008-2009 ON A LAG BASIS (Refer to Payroll Bulletins for Submission Dates) PAYROLL PERIOD CHECK S No. 1 April 3 April 16 April 30 No. 2 April 17 April 30 May 14 No. 3 May 1 May 14 May 28 No. 4 May 15 May 28 June 11 No. 5 May 29 June 11 June 25 No. 6 June 12 June 25 July 9 No. 7 June 26 July 9 July 23 No. 8 July 10 July 23 August 6 No. 9 July 24 August 6 August 20 No. 10 August 7 August 20 September 3 No. 11 August 21 September 3 September 17 No. 12 September 4 September 17 October 1 No. 13 September 18 October 1 October 15 No. 14 October 2 October 15 October 29 No. 15 October 16 October 29 November 12 No. 16 October 30 November 12 November 26 No. 17 November 13 November 26 December 10 No. 18 November 27 December 10 December 24 No. 19 December 11 December 24 January 7 No. 20 December 25 January 7 January 21 No. 21 January 8 January 21 February 4 No. 22 January 22 February 4 February 18 No. 23 February 5 February 18 March 4 No. 24 February 19 March 4 March 18 No. 25 March 5 March 18 April 1 No. 26 March 19 April 1 April 15 Q:\PAYROLL\TRAINING & COMMUNICATION\T&C Share\Lisa\Payroll Calendars 08-09 last updated 10/19/07