Employee Parking Payroll Deduction Authorization Form

Employee Parking Payroll Deduction Authorization Form

PAYROLL AUTHORIZATION ► FULL-TIME FACULTY AND STAFF WHO HAVE BEEN APPROVED TO PARK AT ONE OF OUR MEDICAL CAMPUS PARKING LOCATIONS MUST SUBMIT THIS AUTHORIZATION FORM.

After submitting this form, you will receive an e-mail to acknowledge this request. *Asterisks indicate required fields.

Employee ID#:*

C# or Workday ID

First Name:*

Middle Initial:

Last Name:*

University of Miami Email Address:*

Department:

Preferred Phone:

Phone

PLEASE SELECT THE APPROPRIATE SALARY RANGE AND LOCATION BELOW:

Salary Range Selection*

Salary $35,000 or less

Salary $35,001 or more

PER-DIEM, TEMPORARY STAFF, AND CONTRACTORS MAY PURCHASE PARKING IN PERSON AT THE PUBLIC SAFETY OFFICE BY CHECK OR CREDIT CARD.

Employees with Benefits:

I authorize the University of Miami to deduct the above amount from my paycheck each month on a pre-tax basis until I submit a cancellation in writing. I understand the University will evaluate my salary periodically and adjust the deduction amount as required. The above rates include 7% Florida sales tax and 15% City of Miami parking surcharge for all locations on the Medical campus. I agree to abide by University of Miami Parking rules and policies and understand that violations will result in disciplinary action up to and including possible termination and/or prosecution. In summary, selling, sharing, or giving parking passes to others is forbidden.*

Signature*

Public Safety Administration Office

1501 NW 9th Ave. Suite 100 Miami, FL. 33136

Office: (305) 243-6280 (2)

Email: ppasses@miami.edu

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