Employee Name. Xxxxxxx X. Xxxxxx -------------
Employee Name. The Party who will be hired by the Employer named above must be identified and attached to the Employee role of this contract. Furnish the full name of the Employee where requested. (5)
Employee Name. Date: Department/Site Course/Title Dates Enrolled Total Hours of Course From To Educational Institution: Please specify objectives of the course and its relationship to your job description or a promotional position within the Roseville Joint Union High School District. Attach course description if possible. Employee’s Signature 🞏 Approved �� Not Approved 🞏 Job Related 🞏 Promotion Related 🞏 Supervisor Notified To be completed by the Personnel Department Director of Classified Personnel Date cc: Business Office Employee File Supervisor Professional Growth File Form #60 (b.1) 8/99 Appendix E Roseville Joint Union High School District REQUEST FOR PAYMENT FOR PROFESSIONAL GROWTH UNITS Classified Manager Confidential Staff Classified Staff Employee Name: Date: Department/Site Course/Title Units Earned Dates Enrolled Educational Institution: Employee’s Signature Note: Prior approval and verification of completion is required for compensation. To Be Completed by Personnel Department Course/Grade Verification by: (Check one.) Grade Card Transcript Certification Other: Units – Amount to be paid: X $ = $ Number of Units Amount Per Unit Total Budget Code (to be paid through Payroll Department): 0 1 - 0 0 0 0 - 0 - 2 9 0 0 - 1 5 - 9 4 0 9 - 7 4 1 0 - 1 3 0 - 0 0 - 0 0 0 - 0 0 Tuition: $ (Attach verification.) Budget Code (to be paid through Accounts Payable Department): 0 1 - 0 0 0 0 - 0 - 5 8 0 3 - 1 5 - 9 4 0 9 - 7 4 1 0 - 1 3 0 - 0 0 - 0 0 0 - 0 0 Date: Director of Classified Personnel cc: Business Office Employee File Supervisor Professional Growth File
Employee Name. Effective for amounts paid on or after the first day of the month after ORU receives this completed Agreement, the Employee’s compensation (as defined for Plan purposes) will be reduced by the amount(s) indicated below. ORU will contribute such amount(s) on the Employee’s behalf to annuity contracts and/or mutual funds available under the Oral Xxxxxxx University Retirement Plan (the Plan). The Employee is responsible to allocate Plan contributions amount among the available investment options under the Plan. This Agreement revokes and supersedes all prior agreement of a similar nature. NOTE: The minimum permitted annual deferral contribution is $200. DEFERRAL ELECTIONS: I, the Employee elect to defer the following percentage(s) of my eligible compensation each payroll period, and authorize ORU to reduce my compensation by such amount(s) for contribution to the Plan. I understand that my deferral contributions will be eligible for a 50% employer match by ORU up to 6% of my eligible pay after I have satisfied the age and year of service requirements described in the attached instructions. I understand that the maximum deferral contribution for 2022 is $20,500 unless I am eligible for one of the catch-up elections described below and in the attached instructions. Pre-Tax Deferral Percentage: % Xxxx (After Tax) Deferral Percentage: % Total (Pre-Tax + Xxxx): % Catch-up Elections: I am age 50 or over. My contribution elections above take into account the age 50 catch-up contribution that is available to me for this calendar year (2022 maximum is $6,500). I have completed 15 or more years of full-time equivalent service with ORU. My contribution elections above take into account the special Code Section 403(b) catch-up contribution that is available to me for this calendar year (annual maximum $3,000; lifetime maximum $15,000). (Your Maximum Contribution Calculation from TIAA must be attached to this form). This Agreement is legally binding and irrevocable for both ORU and the Employee with respect to amounts earned while the Agreement is in effect. However, the Employee may terminate or otherwise modify his or her elections, by providing an updated Agreement to the ORU Benefits Department. The change will be implemented as soon as administratively feasible. ORU may terminate or modify this Agreement as necessary to comply with the terms of the Plan or the requirements of the Internal Revenue Code. The contributions made pursuant to this Agreement are subject to ...
Employee Name. Soc. Sec. # or Employee ID # I request that the following be processed as soon as administratively possible or a later effective date of . Start or Change My Voluntary Contribution (fill out A and B) Change My Vendor/Record Keeper (fill out B) Stop My Voluntary Contribution EMPLOYEE VOLUNTARY CONTRIBUTION-NOT ELIGIBLE FOR EMPLOYER CONTRIBUTIONS UNDER UARP (INCLUDING NON-BENEFITS ELIGIBLE EMPLOYEES AND EMPLOYEES GRANDFATHERED UNDER ARTRS OR APERS)—EMPLOYEES ELIGIBLE FOR UNIVERSITY CONTRIBUTIONS UNDER UARP SHOULD COMPLETE DIFFERENT FORM) You should only complete this form if you are NOT eligible for University contributions under the UARP. **TOTAL is the percent you wish to have deducted from your pay, split between before-tax and Xxxx after-tax. Before-Tax % Unless I check the box below, I understand that if I reach the 402(g) deferral limit in effect for the year, my contributions will continue on a before-tax basis under the 457(b) Plan. I do not wish to participate in the 457(b) Plan. Stop my contributions for the remainder of the year when I reach my deferral limit in effect for the 403(b) Plan. Xxxx 403(b) (After-Tax) % **TOTAL = % A VENDOR/RECORD KEEPER – SELECT ONE Complete this section if you are making an initial election or want to change your vendor/record keeper. Fidelity or TIAA I authorize the University to direct voluntary contributions to the selected vendor/record keeper as designated. I understand that I change my selection at any time and that this election cancels out any previous election. I understand that it is my responsibility to read and agree to the Employee Acknowledgements listed on the back of this page. The % election above applies to EMPLOYEE PLAN COMPENSATION, which means all compensation other than: Overtime Terminal Vacation, Sick, Holiday, Compensatory and Severance Pay Expense reimbursements and allowances, student loan repayments, fringe benefits (cash and non-cash), moving expenses and welfare benefits Deferred Compensation Recruiting, Sign-On, Referral, Service and Achievement Awards (not including merit bonuses or career service awards, which are included compensation) Compensation funded by a supporting Foundation other than base salary Employee Signature Date (Human Resources/Benefits use only)
Employee Name. Department: ; Division and Work Location: Date and Time of Occurrence: ; Incident Location: Section I – Direct Evidence of Drug or Alcohol Impairment at Work Smells of Alcohol Smells of Marijuana Observed Consuming/Ingesting Alcohol or Drugs at work. Section II Contemporaneous Event Indicating Possible Drug or Alcohol Impairment at Work: (Check all that apply) 1. SPEECH: Incoherent/Confused Slurred
Employee Name is a unit member, and has duly made it known to the Superintendent and Association that he/she desires to share his/her position with another on a job-share basis for the school year.
Employee Name. The Company and Employee, in consideration of Company's offer of employment to Employee and/or Employee's continuation of employment, hereby agree to the restrictions contained in this Agreement. Employee agrees that all restrictions and covenants made in this Agreement are reasonable; and Employee understands the Company's necessity of such restrictions and agreements.
Employee Name. 10. This Agreement and the Job Sharing arrangement hereunder shall automatically terminate at the end of the school year, without the need for any further notice or action by the Board. Termination of this Agreement/Job Sharing arrangement is not subject to challenge through the grievance procedure in the Master Agreement. Termination of this Agreement/Job Sharing arrangement prior to the end of the school year shall only occur upon agreement of the parties. Upon termination of this Agreement, NAME shall be returned to a full-time position for which she/he is certificated, subject to the provisions of the Master Agreement including Article VII and XIII, unless a new Job Sharing Agreement is agreed to by the Board. This Job Sharing arrangement shall have no precedential value, and any subsequent decision between the same or different parties as to whether or not to enter into a Job Sharing arrangement is discretionary and is not subject to challenge through the grievance procedure in the Master Agreement.
Employee Name. ❑ No Relationship: Are you an employee of another broker-dealer? ❑ Yes... Broker-dealer name: ❑ No Are you related to an employee at another broker-dealer? ❑ Yes... Broker-dealer name: Employee name: ❑ No Relationship: Are you maintaining any other brokerage accounts? ❑ Yes... With what firms(s) are you maintaining other brokerage accounts? ❑ No Years of investment experience: Are you or any member of your immediate family affiliated with or employed by a member of a stock exchange or the Financial Industry Regulatory Authority? ❑ Yes If Yes, employer authorization is required. What is the affiliation? ❑ No Are you a senior officer, director, or 10 or more shareholder of a public company? ❑ Yes... Company name(s) ❑ No IV. SECONDARY ACCOUNT HOLDER INFORMATION SECONDARY ACCOUNT HOLDER Name: ❑ Person ❑ Entity Social Security Number or Taxpayer ID Number: LEGAL ADDRESS ATTN: Address: MAILING ADDRESS (If different) ATTN: Address: City: State: Zip/Postal Code: Province/County/Subdivision: Country: City: State: Zip/Postal Code: Province/County/Subdivision: Country: Country of Citizenship: Telephone Number (Home): Country of Permanent Residence: Telephone Number (Business): E-mail: Gender: ❑ Male ❑ Female Marital Status: ❑ Single ❑ Married Date of Birth: / / EMPLOYMENT INFORMATION Employment Status: ❑ Employed (EMPL) ❑ Unemployed (UEMP) Occupation: Years Employed: ❑ Self-Employed (SEMP) ❑ Homemaker (HOME) ❑ Retired (RETD) ❑ Student (STDT) Type of Business: Employer’s Name: ATTN: Employer’s Address: City: State: Zip/Postal Code: Province/County/Subdivision: Country: FINANCIAL INFORMATION Identify Verification Method Used: ❑ Compliance Data Center Inc. Report (CDCR) Skip this section if aggregated information was already provided. Tax Bracket: ❑ Internal Review (INRV) Annual Income: ❑ 0-15 (LWTB) ❑ Regulatory Data Corporation (RDCR) From: $ To: $ ❑ 15.1 -32 (MDTB) ❑ Other ID Vendor (OTHR) Net Worth (Excluding home): ❑ 32.1 -50 (HITB) From: $ To: $ ❑ 50.1 + (TPTB) Liquid Net Worth: From: $ To: $ UNEXPIRED GOVERNMENT IDENTIFICATION NOTE: Unexpired photo government identification should be provided for all nonresident aliens, along with an IRS Form W-8BEN. ID Verification Comments: GOVERNMENT PHOTO ID #1 GOVERNMENT PHOTO ID #2 Type of Unexpired Photo ID: Type of Unexpired Photo ID: ID Number: ID Number: Country of Issue: Country of Issue: State/Province/Subdivision of ID: State/Province/Subdivision of ID: Date of Issue: / / Date of Expiration: / / Date of Issue: /...
