Student Payroll Payment Authorization

STUDENT RESEARCH STIPEND REQUEST

To: Payroll Department – Leighton 117 (1-BUSOFC) CC: Student Financial Services – Henry House 104 (5-HENRY)

Please pay: ______$______(Name/ID #) (Amount)

Student Position: ______

Charge account number(s): ______(Fund/Source/Department/Object – 5140 Term or 5130 Break)

This stipend payment is for the following dates of work: ______

 Payments are processed within the nearest corresponding payroll dates  See Student Payroll Calendars for pay periods: apps.carleton.edu/campus/business/payroll

Authorized by:

______(Print Name)

______(Signature)

______(Date)

This is taxable income to the student and will be processed through student payroll. If you have any questions, please contact: [email protected] or [email protected].

SUBMIT: 1.) Original to: Jennifer Paulson or Shari Mayer, Payroll – Leighton Hall (1-BUSOFC) 2.) Copy to: Kris Parker or Elizabeth Rowley, Student Financial Services – Scoville (SFS-4)

4/5/2018