SUNY BrockportHuman Resources



Extra Service Approval FormOFFER AND ACCEPTANCE: Authorizations must be submitted and approved PRIOR to the commencement of the extra service work. Return completed, approved forms to Human Resources. Incomplete forms will be returned.I. TO BE COMPLETED BY DEPARTMENT PAYING FOR EXTRA SERVICEEMPLOYEE INFORMATION:Name: FORMTEXT ?????Budget Title: FORMTEXT ?????Base Salary: FORMTEXT ?????Primary Department: FORMTEXT ?????Extra Service Department: FORMTEXT ?????EXTRA SERVICE APPOINTMENT AND COMPENSATION OFFER:Please describe additional work to be performed above and beyond the employee’s professional obligation for this extra service appointment (Refer to the Extra Service policy for what constitutes extra service): FORMTEXT ?????Why is this extra service appointment necessary? FORMTEXT ?????Which of the following SUNY Criteria does this extra service appointment meet? FORMCHECKBOX Staff: Health and Safety?Critical extra service should be prioritized as a last resort. Can other arrangements, staff, reassignments be considered vs extra service?? FORMCHECKBOX Faculty: Instruction and Research Critical extra service can be considered if they are in high-needs, high enrollment and research growth areas as demonstrated by?enrollment applications and research award. FORMCHECKBOX Staff: Student Facing Experience Critical extra service can be considered if they are in areas that would aid in student retention, recruitment, or service. FORMCHECKBOX Staff: Managerial/Operational Critical extra service should be prioritized if the workload is for compliance needs or critical strategic needs. FORMCHECKBOX Faculty and Staff: Revenue Generating Critical extra service should be prioritized if revenue generation is known (in other words, a grant is already identified and in hand or is a fundraiser that comes with an established portfolio). Care should be given, and scrutiny done, to not approve based on the hope of revenue generation.Total Stipend Amount: FORMTEXT ?????Begin Date: FORMTEXT ?????End Date: FORMTEXT ?????Account Number: FORMTEXT ?????Funding Source Information: FORMCHECKBOX Grant/external FORMCHECKBOX Foundation FORMCHECKBOX IFR FORMCHECKBOX StateII. EMPLOYEE ACCEPTANCE OF TEMPORARY EXTRA SERVICE APPOINTMENT FORMCHECKBOX I certify that no work was performed prior to this extra service approval form being completed and approved. _____(Initials) FORMCHECKBOX I certify I accept the foregoing appointment as offered by SUNY Geneseo. In accepting this appointment, I agree to comply with and support all Federal and State laws and all SUNY Geneseo policies. I understand that failure to comply with completion of forms will result in delayed payment until Human Resources is in receipt of correct completed forms. I am required to provide a work log within three business days if so requested. I understand that payment can only be made after work is completed.ACCEPTED: (Employee’s Signature)Date:III. AUTHORIZATION AND APPROVALSBy affixing our signatures below, we certify that no work was completed prior to this extra service form being completed and approved and that the extra compensation requested is for work that is above and beyond normal duties and responsibilities and that such extra work will not interfere with the employee’s regular obligation or this department’s ability to meet its regular professional obligations to the campus. If this is an extra service appointment, we also certify that the service will not exceed the equivalent of 10% of the employee’s base salary for a semester or 20% for an academic year for employees having academic year obligations, or 20% for the full year for employees with calendar year obligations. Extra Service Supervisor:Date: FORMCHECKBOX Approved FORMCHECKBOX DisapprovedPrimary Supervisor: (NOT applicable if Extra Service is same as Primary Supervisor)Date: FORMCHECKBOX Approved FORMCHECKBOX DisapprovedCabinet-level Administrator:Date: FORMCHECKBOX Approved FORMCHECKBOX DisapprovedSUNY HR: Initials ___________Date _______PR Dates:___________# of payments______________Faculty Extra Service Compensation Guidelines During the regular academic obligation period, aside from normal teaching load, scholarship and service, the following service activities are examples of components of a faculty member’s professional obligation, but are not limited to:Student/academic advisementMentoring new facultyMentoring of students in researchAssessment and periodic program review activitiesProctoring exams/guest lecturing for other facultyGrading exams and papersOccasional (short-term) instruction to fill-in for colleagues when necessaryParticipation in ad hoc service activities (recruitment efforts, registration, campus functions, search committees, etc.)Activities related to securing and maintaining accreditationsCollege committee serviceTrainings related to regular professional obligation and professional developmentAccordingly, these duties should typically be performed without extra service compensation. In rare, exceptional cases, additional course load may exceed what can be reasonably accommodated in the faculty member’s work schedule and may constitute a “work overload” for which extra service compensation or other work load adjustments are justified. SUNY GENESEO MATRIX OF REQUIRED EXTRA SERVICE FORMS FOR PAYMENTCURRENTEMPLOYMENTCLASSIFICATION AND PAYMENT TYPEPT OR FT GENESEO EMPLOYEE WORKING EXTRA SERVICEAT GENESEOFT GENESEO EMPLOYEEWORKING EXTRA SERVICEAT ANOTHER SUNY CAMPUS OR OTHER STATE AGENCYPT GENESEO EMPLOYEEWORKING EXTRA SERVICE AT ANOTHER SUNY OR AT OTHER STATE AGENCYPT SUNY OR OTHER STATE AGENCY EMPLOYEE WORKING EXTRA SERVICE AT GENESEOFT OTHER STATE AGENCY EMPLOYEE WORKING EXTRA SERVICE AT GENESEOFT SUNY EMPLOYEEWORKING EXTRA SERVICEAT GENESEOUUP-NU 08FEE ONLYEXTRA SERVICE FORMUP-8 REQUEST FORM Other campus/agency may require additional employment/tax formsDUAL EMPLOYMENT FORMOther campus/agency may require additional employment/tax formsEXTRA SERVICE FORMDUAL EMPLOYMENT FORMHIRE PACKAGE *EXTRA SERVICE FORMDUAL EMPLOYMENT FORMHIRE PACKAGE*EXTRA SERVICE FORMUP-8 REQUEST FORMHIRE PACKAGE*M/C – NU 13FEE ONLYEXTRA SERVICE FORMUP-6UP-6 REQUEST FORMOther campus/agency may require additional employment/tax formsUP-6 REQUEST FORMOther campus/agency may require additional employment/tax formsEXTRA SERVICE FORMUP-6 REQUEST FORMHIRE PACKAGE*. NORMALLY - N/A CALL HUMAN RESOURCES AT 5616 IF YOU ENCOUNTER THIS EXTRA SERVICE SCENARIOEXTRA SERVICE FORMUP-6 REQUEST FORMHIRE PACKAGE*CLASSIFIEDSERVICENU 1 – 6, 61FEE ONLYEXTRA SERVICE FORMDUAL EMPLOMENT FORMOther campus/agency may require additional employment/tax formsDUAL EMPLOYMENT FORMOther campus/agency may require additional employment/tax formsEXTRA SERVICE FORMDUAL EMPLOYMENT FORMHIRE PACKAGE*EXTRA SERVICE FORMDUAL EMPLOYMENT FORMHIRE PACKAGE*EXTRA SERVICE FORMDUAL EMPLOYMENT FORM HIRE PACKAGE*56324504727575*HIRE PACKAGE: I-9OATH OF OFFICEFORM W-4 FORM IT-2104RETIREMENT ELECTION FORMEMPLOYEE INFORMATION FORMNOTE: THIS MUST BE COMPLETED BY ALL FIRST-TIME EXTRA SERVICE OR DUAL EMPLOYMENT HIRES AT GENESEO. IF THERE IS A BREAK IN SERVICE GREATER THAN THREE YEARS, SUNY GENESEO RESERVES THE RIGHT TO REQUEST A BRAND NEW HIRE PACKAGE.00*HIRE PACKAGE: I-9OATH OF OFFICEFORM W-4 FORM IT-2104RETIREMENT ELECTION FORMEMPLOYEE INFORMATION FORMNOTE: THIS MUST BE COMPLETED BY ALL FIRST-TIME EXTRA SERVICE OR DUAL EMPLOYMENT HIRES AT GENESEO. IF THERE IS A BREAK IN SERVICE GREATER THAN THREE YEARS, SUNY GENESEO RESERVES THE RIGHT TO REQUEST A BRAND NEW HIRE PACKAGE.REQUIRED SIGNATURE/APPROVALS: Extra Service FormUP-6EmployeeEmployeeExtra Service SupervisorChief Administrative Officer*Employee’s Primary Department SupervisorCabinet-level AdministratorUP-8Dual Employment FormEmployeeEmployeeCabinet-level AdministratorCabinet-level Administrator * Primary Department/Primary Supervisor not required if extra service employee is from another State Agency or SUNY. ................
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