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Print Gift Certificates Ohio

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					EMPLOYEE AWARD REQUEST FORM                          issued by the Payroll Office, Jan 05
         Ohio University                             740-593-xxxx

Employee Name:
Employee ID:
Job Title:
Department:
Account Number to be charged:

 FT      Fund         Org       Nat Acct   Project      Task (if applicable)

Amount Requested (gross)         $
      Ohio University                                  issued by Payroll Services 740-593-1860 - JAN-05


1 Employee Award Request Form #                                        ER
    See University policy 40.011 prior to filling out this form
    http://www.cats.ohiou.edu/policy/40-011.html

      Type of award:               Incentive Award                  Performance/Acheivement Award

      Method of award:                  Cash            Gift certificate              Gift
      IF CASH:         Gross Amount Requested*:                            $
2      Fill out Section 3 & 6 and forward to Payroll
      IF GIFT CERTIFICATE OR GIFT:                         Value of item*: $
       Fill out Section 3 - 6 and attach to Direct Payment Form , Req, or pcard statement, as appropriate

      * Total value of award(s) may not exceed $1,000 (gross) per employee, per calendar year.
      Cash amounts greater than $25 are taxable income. Gifts over $100 are also taxable.
      Gift certificates that are easily convertible to cash are considered cash.

      Employee Name:
      Employee ID:
      Job Title:
3     Department:
      Account Number to be charged:

         FT           Fund              Org              Nat Acct                  Project                Task (if applicable)

      Describe reason for award. Attach separate sheet if necessary:
    Martha is the best employee ever.
4


      Employee Certification and Signature:
    I certify that I have read and understood Employee Recognition Awards Policy 40.011.


      Signature                                                                                     Date

5 Supervisory Certification and Signature:
    I certify that I have read and understood Employee Recognition Award policy 40.011, and further, that the
       requested award is for a program or for performance or achievement that is keeping with that policy.



      Signature                                                                                           Date

      Authorized Approval:
6
      Planning Unit Head Signature                                                                        Date
     Ohio University                                                                   issued by Payroll Services 740-593-1860 - JAN-05

    Employee Award Request Form                                                            #    ER            000100.0000
1
     click on the red-bordered squares for                  See University policy 40.011 prior to filling out this form
     instructions as you go along.                          http://www.cats.ohiou.edu/policy/40-011.html

     Method of award:                       Cash                      Gift certificate                    Gift
     IF CASH:            Gross Amount Requested*:                                 $
       Fill out Sections 3 - 6 and forward to Payroll
     IF GIFT CERTIFICATE OR GIFT:                                Value of item*: $
2      Fill out Sections 3 - 6 and attach to pcard statement
       OR attach to Direct Payment form or Req and forward to Payroll, as appropriate

     * Total value of award(s) may not exceed a total of $1,000 (gross) per employee, per fiscal year.
      Cash amounts greater than $25 are taxable income. Gifts over $100 are also taxable.
      Gift certificates that are easily convertible to cash are considered cash.


     Employee Name:
     Employee ID:
     Job Title:
3    Department:
     Account Number to be charged:

         FT            Fund                 Org                Nat Acct                    Project               Task (if applicable)
     Type of award:                   Incentive Award                                  Performance/Achievement Award
                             (For Incentive awards, attach approved copy of Appendix A)
    Reason for award:                           Productivity Incentive                           Cost saving suggestion or effort
4                                               Attendance incentive                             One time project or accomplishment
                                                Morale or health incentive                       Service beyond the call of duty
                                                Other                                            Other
     Describe reason for award. If cost savings, describe and quantify $ savings achieved. Attach separate sheet if necessary.




5



     Certification and Signature:
     I certify that I have read and understood Employee Recognition Award policy 40.011, and further, that the
     requested award is for a program or for performance or achievement that is keeping with that policy.
6
         EMPLOYEE Signature                                     Date              SUPERVISOR Signature                              Date


     Authorized Approval:
7
         PLANNING UNIT Signature                                Date              UHR Approval                                      Date
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