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Payroll Services Form for Approved Non-University Affiliate Organizations
 

Summary: Payroll Services Form for Approved
Non-University Affiliate Organizations
The information provided below has been supplied for the purpose of processing payroll for an individual who is not a
university employee. All regulated deductions will be automatically taken each month from the monies stipulated
below. Completed forms must be received by Human Resources (including Financial Services budget approval)
by the 15 of the monthth
*Organization Name:
PERSONAL INFORMATION
*Payroll ID Number: S.I.N.: Gender: Date of Birth:
YYYY/MM/DD
Title: *Surname: * Given Name: Initial:
Home Address:
City: Province: Country: Postal Code:
BANKING INFORMATION
Attach a Void Cheque to the first Payroll Services Form submitted for a person or if a person's banking information changes.
EMPLOYEE AUTHORIZATION
I hereby authorize the release of the above information to Queen's University for the purposes of processing payroll. I understand that I am not
a Queen's University employee and that my employment, including the terms and conditions of employment are solely the responsibility of the
above hiring organization.
(blue ink only)

  

Source: Abolmaesumi, Purang - School of Computing, Queen's University (Kingston)

 

Collections: Computer Technologies and Information Sciences