Environmental Science and Policy
Employment Authorization (GREEN SHEET)
Employee name
Today’s date
Employee or Student I.D. #
Email/phone
Please: *Hire/Extend ____
Change funding ____
Fellowship/Stipend: See note below
Appointment type: Staff ____ Academic ____ UG/G Student
Work Study*
California resident? (to estimate fee remission) _______
Position Title
Step
Account
%
Salary
Effective Dates
Benefits:
BELI 1 ____ Career Status: Medical, Vision and Dental + UCRS (requires 50% for 12 months).
BELI 3 ____ Limited Career: Medical only (NOT in UCRS, appointed 100% for 3 months).
BELI 4 ____ Core Medical (Major medical only; 17.5 hours per week or 43.75%).
BELI 5 ____ Less than 43.75% staff; all students; or without salary status.
Graduate student researchers @ 25% for full quarter receive full FEE REMISSION from grant.

Approvals:
Principal Investigator/Supervisor
Date
Federal Contract Requiring E-Verify
Account Manager
Date
*New student appointments require a brief job description. Provide here or via email. For
work study positions, expand your comments to include job purpose, description of duties
reflecting the level of appointment, and requirements (skills/knowledge/abilities) to perform
the job. Student Employment requires an approved job description before releasing the work
study funds.
Fellowships/Stipends are not paid through Payroll unless student is international. See
department account manager to set up fellowship/stipend payments through Graduate Studies.