Supplemental Pay Intake Form

Supplemental Pay Intake Form

This form is required for the following types of Supplemental Pay:

Part of Job Description
Addition to Job Responsibilities
Research Subject Fee
Staff Temporary Assignment
Student Temporary Assignment
Faculty Temporary Assignment

All others require a signed offer letter attached in the MSS request:

Faculty Temporary Assignment (Administrative)
Academic Administrative Assignment
OMS CS (GT)
Taxable Moving Expenses
Car Allowance
Housing Allowance
Subsistence

For Incentives & Awards, click here

For Temporary Teaching Overload, click here

Requestor Information

Requestor First Name*

Requestor Last Name*

Requestor Email*

HR Partner Contact*

If you do not see your HR Partner's contact in the list, please type in their GT email and hit Enter.

Select or enter value

Employee/Candidate Information

The employee/candidate name must match in MSS request. Use name as it appears in OneUSG Connect – do not use nicknames or abbreviations.

Employee First Name*

Employee Last Name*

Employee Type*

Staff

Faculty

Student

Employee Unit*

Please only select Administration & Finance if the unit is 710.

Select

Employee Department*

Employee ID*

This should be 7 digits long.

Supplemental Pay Information

Type of Supplemental Pay, Effective Start and End Dates, and Monthly Pay Amount must match in MSS request.

Type of Supplemental Pay*

The following Supplemental Pay types are defined term payments (DTRMPs) that occur in multiple pay periods for a defined period and need to go through the Compensation Team for review.

Part of Job Description
Addition to Job Responsibilities

The following Supplemental Pay types are one-time lumpsum payments (OTPAYs) that occur once in a selected pay period and do not need to go through the Compensation Team for review.

Research Subject Fee
Staff Temporary Assignment
Student Temporary Assignment
Faculty Temporary Assignment (OTPAY)

Is the recipient performing tasks related to their regular job (i.e. considered part of the recipient's job description)?*

Yes

Effective Start Date*

Effective End Date*

Supplemental Monthly Pay Amount*

Number of Pay Periods*

Please use two digits (i.e. 00, 01, 10)

Total Pay Amount*

Monthly Pay Amount x Number of Pay Periods

Is this request related to a previous transaction?*

Is there a current/pending transaction in ServiceNow that this request is related to?

Yes

Previous Transaction ID*

This would be the ServiceNow case number the request is related to.

Are multiple combination codes needed?*

Yes

Combination Code 1

Combination Code 2

Combination Code 3

Percent Allocation for Combination Code 1

Percent Allocation for Combination Code 2

Percent Allocation for Combination Code 3

Must add up to 100% with other combination codes.

Provide a detailed description of required duties, date(s), and justification for supplemental payment:*

Include support for “meaningful change in duties and responsibilities” AND, if applicable, vacant position numbers.

Please attach any additional documentation to support this request.

Drag and drop files here or

Privacy Notice|Report Abuse