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Specialconsultantpay

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U.S.A. forms for California State University Channel Islands

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Request for Special Consultant Pay
Academic Affairs
CSU Channel Islands
Refer to the CI Payroll Calendar for the appropriate pay period before completing the dates worked
below. A separate Request for Pay form must be submitted for each pay period. Dates worked cannot
conflict with other special consulting contracts or with Extended University teaching days. Dates
worked on sponsored projects (grants/contracts) must fall within the work week (Mon-Fri).
Pay Period:
Dates Worked. Indicate each date worked individually:
Daily Rate ($):
Number of Days Worked:
Total Amount ($):
Departme nt/P I Author ization S ignature:
Author ization Date:
Consultant Pay Review Verification
Signature
(Callie Juarez or
Beat riz Ruettgers):
Verification Date:
AVP Appr ova l Signature (AVP for home acad emic unit/school ):
Approval Date:
HR/Payroll Office Use Only
PeopleSoft Position Number:
PIMS Position Number:
- - -
Unit #
PIMS Job Record #
Dollar Amt Remaining:
Payroll Authorization
Processed by
Date Processed
Department/Program:
Request Date:
Grant Funded Requests Only
AY Extra Compensation:
Summer/Winter
Compensation:
Cons ultant Name:
Em ployee ID
:
Project Name/Brief Description:
Accounting String:
Clear Form
N/A
N/A
$ 0.00
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Specialconsultantpay

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Completed 23 January 2020

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