COLBY COLLEGE 2015/16
STUDENT PAY REQUEST
IDENTIFYING INFORMATION________________________________________________________________________________
1.
Student's COMPLETE Name __________________________________________________ID Number ____________
2.
Department (by Name and Account Number) _______________________________________________________
3.
Level (Rate) ___________Supervisor's Name (PLEASE PRINT) _________________________________________
___
_______
______
**An ELECTRONIC STUDENT PERSONNEL ACTION FORM (ESPAF) MUST BE COMPLETED (BY EMPLOYER) ONLINE AND THE
STUDENT MUST HAVE COMPLETED AN I-9 BEFORE HE/SHE CAN BE PAID**
_________________________________________________________________________________________________
____
HOURS WORKED__________________________________________________________________________________
__
NUMBER OF HOURS WORKED EACH DAY
(Minimum quarter hour increments)
(WEEK END DATE)
SUN
MON
TUE
WED
THU
FRI
SAT
TOTAL
(DATE)___________
______
_____
_____
_____
_____
_____
_____
________
(DATE)___________
______
_____
_____
_____
_____
_____
_____
________
TOTAL HOURS WORKED: ___________
_________________________________________________________________________________________________________
___
CERTIFICATION_____________________________________________________________________________________
_______
I certify that this pay request is a true statement of hours actually worked by this student and that work has been performed in a satisfactory manner.
SUPERVISOR'S SIGNATURE _______________________________
I have reviewed this pay request and certify it to be a true representation of hours actually worked by me.
STUDENT'S SIGNATURE___________________________________
____________________________________________________________________________________________________________
THIS FORM MUST BE SUBMITTED ON THE MONDAY FOLLOWING THE END OF EACH LISTED PAY PERIOD. FAILURE TO DO SO MAY
RESULT IN A DELAY OF YOUR PAYCHECK UNTIL THE FOLLOWING PAY PERIOD.
Payroll No
Beg Date
End Date
Time Entry Ends
Approval Ends
Pay Date
517
8/16/2015
8/29/2015
8/30/2015 at 2359
9/1/2015 at 1300
9/4/2015
518
8/30/2015
9/12/2015
9/13/2015 at 2359
9/15/2015 at 1300
9/18/2015
519
9/13/2015
9/26/2015
9/27/2015 at 2359
9/29/2015 at 1300
10/2/2015
520
9/27/2015
10/10/2015
10/11/2015 at 2359
10/13/2015 at 1300
10/16/2015
521
10/11/2015
10/24/2015
10/25/2015 at 2359
10/27/2015 at 1300
10/30/2015
522
10/25/2015
11/7/2015
11/8/2015 at 2359
11/10/2015 at 1300
11/13/2015
523
11/8/2015
11/21/2015
11/22/2015 at 2359
11/24/2015 at 1300
11/27/2015
524
11/22/2015
12/5/2015
12/6/2015 at 2359
12/08/2015 at 1300
12/11/2015
525
12/6/2015
12/19/2015
12/20/2015 at 2359
12/22/2015 at 1300
12/24/2015
526
12/20/2015
1/2/2016
1/3/2016 at 2359
1/5/2016 at 1300
1/8/2016
527
1/3/2016
1/16/2016
1/17/2016 at 2359
1/19/2016 at 1300
1/22/2016
528
1/17/2016
1/30/2016
1/31/2016 at 2359
2/2/2016 at 1300
2/5/2016
529
1/31/2016
2/13/2016
2/14/2016 at 2359
2/16/2016 at 1300
2/19/2016
530
2/14/2016
2/27/2016
2/28/2016 at 2359
3/1/2016 at 1300
3/4/2016
531
2/28/2016
3/12/2016
3/13/2016 at 2359
3/15/2016 at 1300
3/18/2016
532
3/13/2016
3/26/2016
3/27/2016 at 2359
3/29/2016 at 1300
4/1/2016
533
3/27/2016
4/9/2016
4/10/2016 at 2359
4/12/2016 at 1300
4/15/2016
534
4/10/2016
4/23/2016
4/24/2016 at 2359
4/26/2016 at 1300
4/29/2016
535
4/24/2016
5/7/2016
5/8/2016 at 2359
5/10/2016 at 1300
5/13/2016
536
5/8/2016
5/21/2016
5/22/2016 at 2359
5/24/2016 at 1300
5/27/2016
537
5/22/2016
6/4/2016
6/5/2016 at 2359
6/7/2016 at 1300
6/10/2016