SOUTH LYON COMMUNITY SCHOOLS
Teacher Supplementary Compensation Form
Administrators shall prepare and have on file the Teacher Supplementary Compensation form which is to
be used by teachers when they complete their assignment and are requesting payment for services rendered.
, have completed  50% or  100% of my assignment of
I,
at  South Lyon High School,  South Lyon East High
School,  Centennial Middle School or  Millennium Middle School for the school year 2015-2016. Request
is herewith submitted for payment of
which represents an initial
payment of  50%, a second payment of  50%, or one payment of  100%, as calculated below:
Date due in Payroll
Date paid to employee
(must be received in Payroll by the 1st or 15th of the month)
Date assignment begins
(actual end date)
Date assignment ends
Schedule C Minimum
$44,905.00
Step Percentage
Total Payment
Payment Request
Teacher
Date
Employee I.D. Number
As program director, I have supervised the work of
assignment of
in the
. Whereas all duties for this position for the
2015-2016 school year have been  50% completed, or  100% completed, I recommend the above payment
request be made.
Principal
Payroll Account Number (for Business Office Use Only)
Date