South Carolina State University

SOUTH CAROLINA STATE UNIVERSITY

Temporary Grant Data Request Form

NOTE: After administrative approvals, please forward this form, along with a Position Description and completed Application for Employment to the Budget Office. The Office of Human Resource Management will notify the supervisor when the Request has been approved after which the employee may report to Human Resources to sign the form and be notified of the date to report to work.

GENERAL POSITION INFORMATION GRANT NUMBER POSITION NUMBER EMPLOYMENT EMPLOYMENT BEGIN DATE END DATE EMPLOYEE ID# LAST NAME FIRST NAME MI POSITION TITLE (Attach Position Description) SUPERVISOR SUPERVISOR NAME TITLE DEPARTMENT INDEX NUMBER PAY RATE: HOURLY SEMI-MONTHLY HOURS PER WEEK TOTAL SALARY TOTAL NUMBER OF WEEKS APPROVAL SIGNATURES DEPARTMENT HEAD DATE VICE PRESIDENT/DIVISION HEAD DATE BUDGET OFFICE ACTION POSITION NUMBER ASSIGNED INDEX NUMBER ACCOUNT NUMBER TOTAL SALARY BUDGET ANALYST SIGNATURE DATE BUDGET DIRECTOR SIGNATURE DATE FORWARDED TO HUMAN RESOURCES DATE OFFICE OF HUMAN RESOURCE MANAGEMENT ACTION POSITION AND SALARY APPROVED DATE ASSIGNMENT INPUT TO HUMAN RESOURCES SYSTEM DATE SUPERVISOR NOTIFIED OF APPROVAL DATE HUMAN RESOURCES SIGNATURE DATE EMPLOYEE CERTIFICATION

I UND E R S T AND T H A T T H IS IS A T E M PO RARY G RANT A S S I G N M E NT AS D E S I G NA T E D A B O VE A ND T H AT T H IS TE M PO RARY G R A NT D A T A R E Q U E S T FO RM D O E S N O T R E P R ES E NT A C O N T R A CT W I T H S O U T H CAR O L I NA S T A T E UNI V E R S I T Y. I AC K N O W LE D G E T H A T T H E L A N G U A G E U S E D IN T H IS D O CU M E NT D O E S N O T C R E A T E A N E M P L O Y M E NT C O N T RA C T BE T W EE N M E AND S O U T H CAR O L I N A S T A T E UNI V E R S I T Y, N O R D O E S IT C R E A T E ANY C O N T RAC T U AL R I G H T S O R E N T I T L E M E N T S. I UN D E RS T A N D T H AT NO P R O M IS E S O R ASSURA N C E S, W H ET H E R WRI TT E N O R O RA L , W H ICH ARE C O N T RA R Y T O O R INC O N S I S TE N T W I T H T H E T E R M S O F T H IS P ARA G RA P H C R E A T E A N Y C O N T RA C T O F E M P L O Y M E N T .

Are you a current member of the S. C. Retirement System? YES NO (If yes, please contact the Office of Human Resource Management) EMPLOYEE SIGNATURE DATE

Form P-14 (Rev. 07/06)