Temporary Appointment Form

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SEAS Temporary Payroll Appointment Form (FY 17) Please return completed form to: SEAS Human Resources Office 20 University Rd, 6th floor (617) 384-7828 First Name: EMPLOYEE Harvard ID : Last Name: Birth Date: Email Address: Office location: Local Address: Have you worked at Harvard University in the last year Yes No Do you currently work for another Harvard University department Yes No Are you receiving federal work study (FWS) Yes No Are you receiving faculty aide support Yes No Will you be working in a lab (If yes, Safety Training is required) Yes No Employee Role: SUPERVISOR / / Cell : Professor/Staff Supervisor: Start Date: / / Hourly Rate: Costing: Hours/week: End Date: / / LHT Please note pay ranges for ĞĚĞƌĂůtŽƌŬ ƚƵĚLJstudents : Undergraduate: 11 - 16 / Graduate: 13.50 - 20 Harvard Student Temp Hours/Week : - - 9999 - - - - - - 9999 - - - - SIGNATURES Name (print) 1 Employee: 2 Faculty/Staff Supervisor: 3 Budget/Research Admin: Signature Date Documentation The following documents must be on file for each employee: • I-9 Employment Verification Form • Foreign National Information Form (International students only) • Federal W-4 Tax Form • Work Permit (under age 18 only) • MA State M-4 Tax Form All forms are available in the SEAS HR office and must be submitted to the HR office prior to the employee’s start date..

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