University of Central Arkansas Payroll Disbursement Office Paycheck by cgg10267

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									            University of Central Arkansas
                              Payroll Disbursement Office
                Paycheck/PayStub Pick-up Authorization Form



     The following employees are authorized to receive the named department's paychecks
and paystubs on the scheduled payroll disbursement dates:



        Primary employee:
                Print name:                              Signature:


     Alternative employee:
                Print name:                              Signature:


     Alternative employee:
                Print name:                              Signature:




  Department:


Print Chair/ Director or Manager's name:
                                                            Print
Chair/ Director or Manager's signature:
                                                          Signature
        Date:




   Disbursement Auth sheet                                                        10/30/2003

								
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