Hope College Business Services: Faculty/Staff Over & Above Request
FACULTY/STAFF
"Over & Above" Wage Payment Request

For services performed in addition to the contracted/regular salary, please pay to:

Name: _________________________________________ Hope ID#: _________________________
Amount: $ ___________________ (gross amount only - do not include benefits)
# of payments: ____ One lump sum in the next regular payroll
____ _____ Equal installments beginning ____________

Fund (5 digits):_______________ Account

check one

____ 6110 Faculty - Full time
____ 6111 Faculty - Part time
____ 6115 Stipend
____ 6120 Admin. - Full time
____ 6121 Admin. - Part time
Description of Services Provided:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Requested by: _____________________________________ Date: _______________
Approved: _____________________________________
Dean/Supervisor
_____________________________________
Provost/Vice-President
_____________________________________
Business Services
____________
Date
____________
Date
____________
Date

 

PAYROLL OFFICE USE

Retirement Eligible ________

Check if eligible for retirement. Generally only payments from grants are eligible for retirement.