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  TRUST FUND EMPLOYEE AUTHORIZATION FORM

 

SELECT ONE                                 Student/school year - CCCC5      Student/school break – CCC05         Contractor - CCC09

 

 

GL TRUST FUND      

ACCOUNT NUMBER:

 

NAME:

       (Please Print )

ADDRESS:

 

 

 

 

TELEPHONE NUMBER:   

 

 

Have you ever been employed by MassArt?               Yes              No       

 

If you answered yes above please enter

your payroll identification number here:

 

SUPERVISOR’S NAME:                

        (Please Print )

 

DEPARTMENT:

 

 

RATE OF PAY:                                          ( Minimum wage is $11.00)                                       

                                  (Hourly)                   

CONTRACT                    CONTRACT

BEGIN DATE:             END DATE:                   

 

AUTHORIZED DEPARTMENT

SIGNATORY NAME:

                                                                           (Please Print )

AUTHORIZED DEPARTMENT

SIGNATORYAPPROVAL:

                           (Signature & Date)

 

 

  1. GL trust Fund Account number – enter the general ledger account number from your budget where this employee’s time will be charged. The last five characters designate which category the employee is in. It is imperative that you enter a code. There are serious tax implications for each category.

 

  1. Print name, address & phone number of the employee

 

  1. If the employee has worked for MassArt in the past, check yes and enter the payroll identification number. If the number is unknown, leave it blank.

 

  1. Enter the supervisor’s name and the name of the department.

 

  1. Enter the hourly rate of pay. Please note stipends and lump sum payments are no longer allowed.

 

  1. Enter the beginning and ending contract dates. All new hires must be processed by Human Resources before they can begin working. All paperwork must be complete within the first 3 days of working.

 

  1. Authorized department signatory/fund custodian must print, sign and date the form before submission.