stipend form by ppe16615


									                                                                                                                                                             Revised 06.2009
                  The University of Winnipeg                                                                               FOR PAYROLL USE

                            Year                   /                                        Employee #:

                                                                                           Systems ID #:
 Lab Demonstrator Stipend                                                                                             [ ] New                 [ ] Existing

                                                         complete the blue sections only
                                     City / Province:
                                             Phone #:
                               Social Insurance No.:                                Employees will be on Payroll with the exact name that appears on SIN card

                                            Birthdate:                              If non resident a copy of work/study visa also required. If SIN card is not available

                                              Gender:                               or name on card is not current, apply at any Service Canada office for a replacement

                                    Course Number:
                               Start Date of Course:
                                End Date of Course:
          To CALCULATE TOTAL STIPEND PAYMENT - add rate of pay (without vac pay) beside appropriate qualifications in blue box
         below (Rates of Pay for Non Union classifications on website under Faculty and Staff / HR / Payroll), add total # of hours to be
             worked, then complete the Stat Pay calculation below (will automatically add to total) this is the total stipend payment

           Qualifications                  (do not include vac pay) rate of pay      rate x hrs + Vac pay                 total stipend including stat pay & VAC pay
          1 Yr of University         ( 0-29 credit hrs)                                      $               -                                                              0.00
         2 Yrs of University         (30-59 credit hrs)                                      $               -                                                              0.00
         3 Yrs of University         (60-90 credit hrs)                                      $               -                                                              0.00
          Total Number of Hours to be Worked:                                                             Employment Insurance (EI) Hours
stat pay calculation    complete the blue sections and the stat pay will automatically be added to stipend amount above
  hrs / week            4 wk period        rate of pay              5% stat pay              # of stats     = stat pay to be added to stipend
                  x            4       x                      x              0.05    x                                                           0.00

                                   Stipend Amount:                                       put in total stipend including stat & Vac Pay from above
                             Number of Payments:                                                          Payroll paid on a biweekly schedule.
                                   Amount Per Pay:                 #DIV/0!                           Payroll payments are by direct deposit only.
                               First Payment Date:
                               Last Payment Date:
                                   Account #:               010-                    - 70344 - 000
                              Contact Person:
            Deadline to be received in Payroll:                                   (minimum 10 working days prior to pay date)

                                                                  IMPORTANT NOTES
                        All Payments are subject to the required deductions of Employment Insurance, Canada Pension,
                             Federal and Provincial Tax. All Payments include Vacation Pay and eligible Stat Pay.
                              Statement Self Service (on-line pay statements & T4 tax forms) is available to all employees.
                Direct deposit information, TD1 tax forms and a copy of SIN card must accompany payments for new employees.

                                                    Signature:                                                                                  Date:


Dept Chair/Grantee

Human Resources

                                            Please retain copy of required documents for your files

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