311-T Change

311-T CHANGE FORM

Directions: Submit to Human Resources to effect a change to the employee's record. Use this form for the all employees on the contractual file (Contingent I and II, student assistants, college work study, graduate assistants and Adjuncts. Adjuncts can also be processed as a cancellation on another form. * MANDATORY

Employee:*	SSN (###-##-####):*
Department:*	(Only used for College Work Study appointments) Account #: (#-#####-####)
EEffective Date of Change:*

Changes:
1. Terminate from Payroll as of (Date):
Reason for termination :

2. Continuation of College Work Study Assignment:
Contract: Begin Date: End Date:

3. Name Change: From: To:

4. Rate of Pay: From: To:

5. Change Total Contract amount: From: To:

Note:
a)     Student assistant contract rates are set forth on the back of the contract.
b)     Adjunct contract rates are authorized by the Dean, Provost and/or President.
c)     Regular contract rates are determined by Human Resources. Any new pay rate change must
        be supported by the position description form and approved by the Associate Director of Human
        Resources prior to completion of the Change form.

6. Program Change or Fund Change
Program: From: To: Fund: From: To:

7. Account Number Change:      From:                To:
                                                             #-#####-####   (10 digits)                                                   (10 digits)
8. Other (describe):

Approved by:
Department Head: ___________________________________________   Date: ________________________
Grants Accountant: __________________________________________   Date: ________________________
(if Grant funded position)

HRS ONLY: Job Code: ________ Contract Maximum: $_________________ Class Code:__ __ ___ __ ___ ___ Assign End Date:____/_____/______

M-311chg: Rev 7/22/97