AUTHORIZATION FOR SALARY DEDUCTION FORM INSTRUCTIONS
Last Revision: 09/28/2021

AUTHORIZATION FOR SALARY DEDUCTION

Form Instructions

  1. Type - Select one of three options. Check the appropriate block indicating that this is the Initial Authorization, a change, or the termination of the Authorization for Salary Deduction
  2. PSU-ID - Enter the employees PSU ID number
  3. Name - Enter the Employee's name
  4. Classification - Select one of seven options from the drop-down list. The options include Academic, Academic Administration, Administrator, Executive, Exempt Staff, Nonexempt Staff, and Technical Service
  5. Position - Enter the name of the employee's position
  6. Department Name - Enter the department name
  7. Furnished date - Enter the beginning date that PSU will furnish meals and/or lodging
  8. Furnished - Select one of two options. If there is an ending date select the first box and provide the date of the last payment. If the deduction is to continue indefinitely, select the second box
  9. Lodging - Enter the location of lodging (if applicable)
  10. Deduct date - Enter the beginning date of salary deduction
  11. Deduct - Select one of two options. If there is an ending date, select the first box and provide the date of the last payment. If the deduction is to continue indefinitely, select the second box
  12. Table - The following information will be entered into a table consisting of eight columns and three rows. The first row pertains to information for the fall semester. The second row pertains to information for the spring semester. The third row pertains to information for the summer semester. There is also a Totals row and these fields automatically calculate - No entry necessary. The columns are as follows:
    • Column 1 - Location of Meals - Enter the name of building where meals are received
    • Column 2 - # of meals - Enter the number of meals received per day
    • Column 3 - Meals - Enter the dollar amount of charges for meals. Enter numbers only. The leading dollar sign has been provided
    • Column 4 - Room - Enter the dollar amount for room charges. Enter numbers only. The leading dollar sign has been provided
    • Column 5 - Family Dwelling - Enter the dollar amount for Family Dwelling charges (if applicable). Enter numbers only. The leading dollar sign has been provided
    • Column 6 - Other (Specify) - If any other charges incurred, provide a description of such charges
    • Column 7 - Other Amount - Enter the dollar amount of any other charges. Enter numbers only. The leading dollar sign has been provided
    • Column 8 - Totals - Each of these fields are calculated. No entry necessary
  13. Pay Periods - Enter the number of pay periods over which the total deductions are to be divided
  14. Deduction Per Pay Period - This is a calculated field. No entry necessary. This is the amount to be deducted per pay period
  15. Comments - Enter any clarifying comments pertinent to this deduction
  16. Employee's Signature - The employee must provide a hand-written signature or provide their digital ID
  17. Employee Signature Date - If the employee provided a hand-written signature, enter the date the form was signed in the next field. If they provided a digital ID, skip the date field
  18. Distribution of Credits table - The following information will be entered into a table consisting of four columns and three rows. The columns are as follows:
    1. Cost Object Type
    2. Cost Object Number
    3. Business Area Number
    4. General Ledger Account Number
    5. Grant number
    6. Project Number
    7. Amount
    NOTE:The Distribution of Credits table contains three rows for data entry. If additional rows are required, omit completing this table and create a spreadsheet to be submitted with this form using the same header titles.
  19. Premise - Select one of two options. Select the first box if the meals and/or lodging will be furnished on University premises. Select the second box if the meals and/or lodging will not be on University premises
  20. Convenience - Select one of two options. Select the first box if the meals and/or lodging are furnished for the convenience of the University. Select the second box if the meals and/or lodging are furnished for the convenience of the employee. In order to be considered "convenience of the University" an employee must accept room and/or meals furnished on University premises as a condition of employment
  21. Explain - If the meals and/or lodging are furnished for the convenience of the University, explain why
  22. Approval - The Budget Administration must provide a hand-written signature or provide their digital ID
  23. Budget Administrator Date - If the Budget Administrator provides a hand-written signature, enter the date the form was signed. If they provide a digital ID, skip this field
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