ࡱ> MOLy Q=bjbj 8@{{d lllll84t|`````      $5!#.El.ll``4spl`l``Il:0m$,Hm$m$l^vL..tm$ 2: Florida Agricultural & Mechanical University PAYROLL DEPARTMENT Off Cycle Payment Request Last Name First Name Empl # and rcd# Department Name Department Funding Number Pay Period:  Check One: X To Be Direct Deposit % To be mailed % To be picked upREASON FOR REQUEST: % Timesheet not received % Hours not keyed properly % Inactive Status in HR or Payroll % Other ________How you intend to prevent this type of error in the future? Earning Code: Hours Hourly Rate Employee Category Job Title Job Code Funding Number Working Department Comments: PREPARED BY PHONEDATEDEPT. AUTHORIZED SIGNATUREPHONEDATE FOR PAYROLL USE ONLY: Amount paid for this request: ___________  ALL REQUESTS MUST HAVE COPY OF CERTIFICATION OR TIMESHEETS ATTACHED TO THIS DOCUMENT OFF CYCLE PAYMENT REQUEST INSTRUCTIONS The Off Cycle Payment Request Form is completed by the Department and forwarded to Payroll Services for processing. This form may be either hand delivered to Payroll, Rm#211, Foote-Hilyer Administrative Center, Tallahassee, Florida 32307, or faxed to 850-561-2080. Name: Enter the employees primary name as it appears in the system. Empl ID: Enter the employees Empl ID Dept. Number: From Job data, enter the Department number as it appears for that Record Number Company: From Job Data, enter the Company as it appears for that record number Job Code: From Job data, enter the Job Code as it appears for that record number Pay Period Ending: Enter the Pay Period End date for which the employee was not partially or totally paid Check One: Check if the check is to be mailed or picked up at Payroll services Distribution Section: If the employee is hourly or exception hourly, enter the earning code, hours and hourly rate to be paid on this request. Two lines are provided. If additional lines are needed, attach a second form. If the employee is salaried, enter the earning code and salary amount. Two lines are provided. If additional lines are needed, attach a second form. 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Complete the Distributions section for each line. Comments: Enter any comments. Prepared By, Phone, and Date: Signature of the individual that completes the form. Dept. Authorized Signature, Phone, and Date: To be signed by the authorized personnel within your department.     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