REHIRE - STUDENT CASUAL CHECKLIST

Complete and return the enclosed forms to Shart³ss England within 72 hours of your employment start date.

☐ Employee Personal Record Form Your supervisor should complete the bottom portion of the form.

☐ Columbia University Casual Employment Form

☐ Notice and Acknowledgement of Pay Rate and Pay Day form (Please sign and date item #8)

☐ International Students: Please bring the following documents when submitting paperwork to HR:

Passport, visa, I-20, and I-94. The I-94 form can be printed from www.cbp.gov/I94. International Students also need a US Social Security Number, or you need to register for one. Please let HR know if you do not have a US Social Security Number or have not registered for one yet.

☐ All students are required to provide proof of their student status. (e.g. registration schedule, bursar’s

receipt).

☐ Students are only permitted to work a total of 20 hours per week during the academic year. Please let

HR know if you hold another position outside of the Law School and how many hours you are scheduled to work in that department. FAQ Where do I submit my Student Casual paperwork? The completed packet should be submitted to Shart³ss England. She is located in room 201 William C. Warren Hall. If you have questions, her office hours are Monday - Friday from 9am-5pm.

Where to submit completed timesheets or get blank timesheets? Submit completed timesheets and pick up blank timesheets outside of room 201 William C. Warren Hall. How long will it take to get your first check? Once your employment packet is complete and submitted to HR, please note that it can take up to 2-3 weeks for processing. Where should you pick up your paycheck? Paychecks can be picked up on the corresponding pay day (see pay schedule on back of the timesheet in this packet) from Shart³ss England’s office, room 201 William C. Warren Hall. If your forms/timesheets are submitted late, your paychecks will be processed on the next pay cycle.

How can you apply for direct deposit? After receiving your first paycheck, please sign up for direct deposit at Columbia’s employee self-service site (see details in the back of this packet). Having direct deposit on SSOL does NOT mean you have direct deposit for your paycheck.

EMPLOYEE PERSONAL RECORD FORM

Name:__________________________________________ UNI:____________ Gender: Male / Female

Social Security #:_______________________________ Date of Birth (mm/dd/yy): ____________________

Home/Permanent Address:

_______________________________________

_______________________________________

Mailing Address:

_________________________________________

_________________________________________

Local Telephone:_______________________ E-Mail:_____________________________________

Ethnicity:___________________ Marital Status: ________________ Date of Marriage: __________________

Please check if you are:

U.S. Citizen ________ Permanent Resident (provide your card) ________ Other (F1 or J1 Visa?) ____________

ARE YOU A COLUMBIA STUDENT? YES____or NO**____ If YES, anticipated year of graduation ___________

**If you are not a Columbia student, you must use a different form. Please inquire: sengland@law.columbia.edu, (212) 851-7529.

DO YOU HAVE WORK STUDY FUNDS? Please stop by your school’s Financial Aid Office, to see if you are eligible for

Work-Study Funds.

SCHOOL: Columbia (which school?) _____________________ Barnard _________ Teacher’s College __________

STUDENT STATUS: Full Time___ Part Time ___Highest Edu. Level: ______Received date_________School________

Please provide proof of student status (ex: Class schedule or bursar’s receipt)

Were you previously employed by Columbia University? Yes_____No_____ IF YES: Termination Date____________________________ School: __________________________________

************************TO BE COMPLETED BY SUPERVISOR****************************

Hiring Department: ______________________________________________________________________________

Job Title / Description: __________________________________ Hourly rate: ____________________________

Start Date: ___________________________________________ End Date: _______________________________

Name of Supervisor (please print):____________________________________________________________________

Supervisor’s Signature: ______________________________________________ Date ________________________

***********Supervisor, please confirm the below with the Business Office *******************

Combo Code: ____________________ Fund Dept #:_________________ Project #:___________________

PAY INFORMATION

Preparer's Name:

Preparer's Titler:

EMPLOYER EMPLOYEE INFORMATION

WORKSITE INFORMATION

Blood borne pathogens

Formaldehyde/Xylene

Chemicals

Laboratory animals

Class 3b or 4a lasers

Infectious agents (e.g. varicella, polio)

Radioactive materials

Will any of the following be present at the worksite:

FOR COLUMBIA UNIVERSITY MEDICAL CENTER ONLY

Be required to use a respirator

Interact with patients and/or research subjects

Participate in physician billing

Will the casual employee:

NOTICE TO THE CASUAL EMPLOYEE

Your rate of pay:

Designated pay day: All casual employees are paid on a bi-weekly pay schedule. For more information on the University's payroll calendar, please refer to: http://finance.columbia.edu/controller/payroll

I understand that my employment with Columbia University is on a “casual” basis. I understand that the estimated duration of my employment with the University should not exceed 560 hours or 4 months, whichever comes first, in a 12-month period with limited exceptions. This limited duration does not apply to students who are enrolled half-time or more at Columbia University, Barnard College or Teachers College. If a student at Columbia University, Barnard College or Teachers College, please indicate: I understand that as a “casual” employee I am not eligible for any benefits offered by the University under any collective bargaining agreement or University policy. I understand that I may apply for and be considered for regular employment by the University for any position for which I am qualified. I understand that I am an employee at will and agree that no contract of employment is created as a result of my obtaining this position, and that my employment may be terminated at any time.1

SIGNATURE

Name:

Apt.

City State

Zip Phone

Columbia University

FEIN: 13-5598093

Street Address: 615 West 131st Street City: New York State: NY

Zip: 10027 Phone: (212) 851-7008

per hour per hourYour overtime rate of pay:

I hereby certify that I have read the above and the information contained in this form is true and accurate to the best of my knowledge and belief. Any false statements knowingly made are punishable as a class A misdemeanor (Section 210.45 of the New York State Penal Law).

Date: Preparer's Signature:

I have read and understand the above referenced terms and conditions regarding my casual employment status at Columbia University. I hereby asknowledge that I have been notified of my wage rate, overtime rate, and designated pay day on the date set forth below.

Signature of casual employee:Date:

Almost all employees in New York must be paid overtime wages of 1½ times their regular rate of pay for allhours worked over 40 per workweek. A very limited number of specific categories of employees are covered by overtime at a lower overtime rate or not at all.

GENERAL STATEMENT REGARDING OVERTIME PAY IN NEW YORK

Address:

Full-time/Half-time Undergraduate Part-time Undergraduate Part-time GraduateFull-time/Half-time Graduate

615 West 131st Street 4th floor mail code 8702 New York, NY 10027 (212) 851-2888

COLUMBIA UNIVERSITY CASUAL EMPLOYMENT FORM

1As a member of the National Collegiate Athletic Association (NCAA) and the Council of Ivy Group Presidents (Ivy League), it is imperative that members of the Columbia University community, in all matters related to the intercollegiate athletics program, exhibit the highest professional standards and ethical behavior with regard to adherence to NCAA, Conference, University, and Department of Intercollegiate Athletics and Physical Education rules and regulations.

A signed copy of this form must be attached to the Template-Based Hire transaction or the signed original must be attached to the Personnel Action Form (PAF) being sent to the Human Resources Processing Center. A copy should be retained by the hiring unit. No representative of Columbia University is authorized to vary the terms of this agreement except by written approval from Human Resources.

Print Form

Rev. 9.2010

Notice and Acknowledgement of Pay Rate and Payday Under Section 195.1 of the New York State Labor Law

Notice for Hourly Rate Employees

1. Employer Information Name: Trustees of Columbia University in the City of New York Doing Business As (DBA) Name(s):Columbia University FEIN (optional): 13-5598093 Physical Address: Mailing Address: 615 West 131st StreetStudebaker, 4th FloorNew York, NY 10027

Phone: (212) 851-0611

2. Notice given: At hiring

On or before February 1

Before a change in pay rate(s), allowances claimed or payday

LS 54 (03/11)

3. Employee’s rate of pay:

$ per hour *Union employees may also be eligible for shift

differential. See the applicable collective bargaining agreement. 4. Allowances taken:

None

Tips per hour

Meals per meal

Lodging

* As provided for under the applicablecollective bargaining agreement:http://hr.columbia.edu/union-contracts

6. Pay is:

Weekly

Bi-weekly

Other 7. Overtime Pay Rate:

$ per hour (This must be at least 1½ times the worker’s regular rate, with few exceptions.)

*See comment above re: shift differential.

8. Employee Acknowledgement:

On this day I have been notified of my pay rate, overtime rate (if eligible), allowances, and designated payday on the date given below. I told my employer what my primary language is.

Check one:

I have been given this pay notice in English because it is my primary language.

5. Regular payday: Columbia Pay Calendar: http://managers.hr.columbia.edu/tig/pay-calendar-overview

My primary language is . I have been given this pay notice in English only, because the Department of Labor does not yet offer a pay notice form in my primary language.

Employee Signature Date Preparer Name and Title The employee must receive a signed copy of this form. The employer must keep the original for 6 years.

Employee Name

COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

HUMAN RESOURCES

Studebaker MC 8705 615 W. 131st Street, 4th Floor New York, NY 10027

Re: Paid Family Leave Waiver Cover Letter for New Hires Dear New Columbia University Colleague: New York State’s Paid Family Leave Law (PFL) provides family leave benefits to eligible employees through a small employee payroll deduction. Eligible employees can take a job-protected paid family leave to bond with a child during the first 12 months following the birth, adoption or fostering of a child, to care for a sick family member with a serious health condition, or for qualifying exigencies arising out of a family member’s covered active duty in the military. To be eligible for PFL, you must be working in New York State and either:

Regularly work 20 hours or more per week, after 26 consecutive weeks; or

Regularly work less than 20 hours per week, after 175 days worked (not consecutive days employed) If your regular schedule is less than 26 consecutive weeks or 175 days in a 52 consecutive week period, you may waive the PFL payroll deduction by completing the accompanying Employee Opt-Out of Paid Family Leave Benefits (PFL-Waiver) Form. Important If you waive the PFL payroll deduction and a change in your schedule requires you to continue working either: a) 20 hours or more per week for 26 or more consecutive weeks or (b) less than 20 hours per week and at least 175 days in a 52 consecutive week period, the waiver form you submitted will be revoked and the appropriate payroll deductions will be made from your wages. In addition, Columbia University will deduct all retroactive amounts due once you are notified. Please carefully consider your work schedule and only submit a waiver if your regular work schedule will not reach the eligbility requirements. If you choose to waive the PFL benefits, please complete the attached PFL-Waiver Form, and submit it to your Departmental HR Contact along with any other new hire paperwork you have completed. If you are not waiving PFL benefits, please check the box below, fill out the requested information and submit this letter to your Departmental HR Contact along with any other new hire paperwork you have completed.

☐I choose not to waive the Paid Family Leave benefits and permit Columbia University to begin payroll

deductions beginning from my date of hire. Print Name: Signature: Department Name: UNI: Date: Note to Department: This letter and the PFL-Waiver Form must be provided to the following employees at the time of hire:

Casuals (Student and Non-Student)

Federal Work-Study Students

Variable Hours Officers

Part-time employees whose standard hours are less than 20 hours a week

Employees who work more than 20 hours per week, but have a total work expectancy of less than 26 weeks

Information on the option to opt-out of paid family leave and directions for completing this form can be found on page 2.

PFL-WAIVER (9-17) Page 1 of 2

1. I would like to waive paid family leave coverage at this time because (select one): 2. I understand that this waiver is revoked if my work schedule changes and it is anticipated I will work more than 20 hours per week for 6

months, or will work less than 20 hours per week but at least 175 days in a 52 consecutive week period (1 year). 3. I understand that this waiver is OPTIONAL AND REVOCABLE. (a) My employer may not force me to opt out of paid family leave benefits. (b) I may decide later to revoke this waiver even if my schedule does not change. 4. I also understand if this waiver is revoked (either by me or by a change in my work schedule), my employer may take retroactive

deductions for the period of time I was covered by this waiver, and this period of time counts towards my eligibility for paid family leave. I certify to the best of my knowledge the foregoing statements are complete and true.

Employer Information1. EMPLOYER'S LEGAL NAME, INCLUDING (DBA/AKA/TA)

2. ADDRESS 4. EMPLOYER FEIN

3. CITY, STATE and ZIP CODE 5. TELEPHONE NUMBER

Employee Information6. EMPLOYEE NAME

7. HOME ADDRESS

8. CITY, STATE and ZIP CODE 9. TELEPHONE NUMBER

12. IS THIS JOB TEMPORARY?Employment Information10. AVERAGE NUMBER OF HOURS WORKED PER WEEK (BASED ON LAST 8 WEEKS)

11. AVERAGE NUMBER OF DAYS WORKED PER WEEK (BASED ON LAST 8 WEEKS) IF YES, HOW LONG IS THE JOB EXPECTED TO LAST?

YES NO

I regularly work 20 hours or more per week, but will not work 26 consecutive weeks (6 months) for this employer.I regularly work less than 20 hours per week, but will not work 175 days in 52 consecutive weeks (a year) for this employer.

EMPLOYEE OPT-OUT OF PAID FAMILY LEAVE BENEFITS

If you need assistance, contact the Paid Family Leave Helpline at (844)-337-6303

www.ny.gov/PaidFamilyLeave

Employee Affirmation

Certification

Please note: Employer must keep a copy of the fully executed waiver on file for as long as the employee remains in employment with the covered employer.

Date Signed:Employee's Signature:

Date Signed:Employer's Signature:

Opting Out of Paid Family Leave (12 NYCRR 380-2.6) (a) An employee of a covered employer shall be provided the option to file a waiver of family leave benefits: (i) When his or her regular employment schedule is 20 hours or more per week but the employee will not work 26

consecutive weeks, or (ii) When his or her regular employment schedule is less than 20 hours per week and the employee will not work

175 days in a 52 consecutive week period.

(b) Within eight weeks of any change in the regular work schedule for an employee that requires the employee to continue working for 26 consecutive weeks or 175 days in a 52 consecutive week period, any waiver filed under this section shall be deemed revoked. An employee of a covered employer whose waiver has been revoked shall be obligated to begin making contributions to the cost of family leave benefits, including any retroactive amounts due from date of hire, pursuant to Section 209 of the Workers' Compensation Law, as soon as the employee is notified by the covered employer of such obligation.

(c) The covered employer shall keep a copy of the fully executed waiver on file to be produced at the request of the Chair, for as long as the employee remains in employment with the covered employer.

(d) An employee as described in Subsection (a) of this Section who elects not to enter into a waiver shall make regular family benefit contributions for the full duration of his or her employment with the covered employer, and the covered employer shall be obligated to provide family leave benefits for such employee when he or she is eligible pursuant to this Title.

Calculating Average Hours/Days Worked

To determine the average number of hours worked per week: Add all hours worked for the past 8 weeks then divide the total by 8. To determine the average number of days worked per week: Add all days worked for the past 8 weeks then divide the total by 8. Example:

PFL-WAIVER (9-17) Page 2 of 2

Week Worked Hours Worked Days WorkedWeek1 16 2Week 2 24 3Week 3 16 2Week 4 16 2Week 5 8 1Week 6 24 3Week 7 16 2Week 8 8 1

Total 128 16Divide by 8 Divide by 8

Average Per Week 16 2

Day In Out In Out Total Hours Supervisor Initials/

Note

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Total Regular

Hours

Approved

Overtime Hours

Employee signature: ___________________________________

Bi-Weekly Casual Time Sheet

Prior Balance PLUS Additional Time Earned (If Any) MINUS Total Used New Balance (As of the End of the Current Bi-weekly Pay Cycle)

NYC Sick Leave (Fiscal Year)

Supervisor Signature and Date: ______________________________

Employee Name

Department/Admin Unit

Total Hours Worked in Period

Day In Out In Out Total Hours Supervisor Initials/

Note

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Total Regular

Hours

Approved

Overtime Hours

Week 2: Period Covered: to Week 1: Period Covered: to

Employee ID

Unit Account Dept PC Bus unit Project Activity Initiative Segment Site

ComboCode or ChartString (Optional): ComboCode

Instructions: Enter (digitally or in ink) time in and out, and hours worked on a daily basis. Any employee who works more than five hours must take at least a 30‐minute break and exclude this time from the total hours. Please Note: Completion of time sheets is a legal requirement of the Fair Labor Standards Act and a negotiated contractual requirement. This form must be prepared for each casual employee, signed by the employee, and submitted to the employee’s supervisor at the close of each two-week period, where it is signed by the supervisor. The hours must then be entered into FFE for the employee. For the payroll calendar, please go to: http://finance.columbia.edu/controller/payroll/index.html Columbia University complies with the New York City Earned Sick Time Act by providing eligible faculty and staff the ability to accrue up to a maxi‐mum of 40 hours per fiscal year in paid sick time, which can be used for illness or preventative care of one's self or one's family members (defined under the Act to mean the employee's child, spouse, domestic partner, parent, sibling (including a half sibling, step sibling, or sibling related through adoption), grandchild, grandparent, or the child or parent of an employee's spouse or domestic partner). Casual employees are eligible for paid sick leave at a rate of 1 hour for every 30 hours worked, up to a maximum of 40 hours in a year. This time must be taken in 1-hour increments. For more information on the NYC Sick Leave, please see the New York City Earned Sick Time Act Policy in the Administrative Policy Library at http://policylibrary.columbia.edu/new-york-city-earned-sick-time-act.

Bi-Weekly Casual Time Sheet

Timesheets are to be submitted to the Human Resources Office, Room 201 WCW by 2:00pm

on the date listed under TIMESHEET DUE below. These dates are subject to change

especially during holiday periods. Please check regularly with the Human Resources Office for

changes in the schedule.

Please follow the instructions on your timesheet and fill it out completely. Timesheets must be signed by both the Employee and the Supervisor. Incomplete timesheets will result in the

delayed release of paychecks. If you are unable to submit your timesheet by the scheduled

deadline, or if you have questions or concerns, please contact Larisha Ingles at: 212-854-7427,

lingle@law.columbia.edu, or hr@law.columbia.edu.

TIMESHEET

WK# PERIOD COVERED DUE PAY DAY

1 06/26/17 - 07/09/17 07/07/17 07/14/17

2 07/10/17 - 07/23/17 07/21/17 07/28/17

3 07/24/17 - 08/06/17 08/04/17 08/11/17

4 08/07/17 - 08/20/17 08/18/17 08/25/17

*5 08/21/17 - 09/03/17 Noon 08/31/17 09/08/17

6 09/04/17 - 09/17/17 09/15/17 09/22/17

7 09/18/17 - 10/01/17 09/29/17 10/06/17

8 10/02/17 - 10/15/17 10/13/17 10/20/17

9 10/16/17 - 10/29/17 10/27/17 11/03/17

10 10/30/17 - 11/12/17 11/10/17 11/17/17

11 11/13/17 - 11/26/17 Noon 11/22/2017 12/01/17

12 11/27/17 - 12/10/17 12/08/17 12/15/17

*13 12/11/17 - 12/24/17 Noon 12/20/2017 12/29/17

14 12/25/17 - 01/07/18 01/05/18 01/12/18

15 01/08/18 - 01/21/18 01/19/18 01/26/18

16 01/22/18 - 02/04/18 02/02/18 02/09/18

17 02/05/18 - 02/18/18 02/16/18 02/23/18

18 02/19/18 - 03/04/18 03/02/18 03/09/18

19 03/05/18 - 03/18/18 03/16/18 03/23/18

20 03/19/18 - 04/01/18 03/30/18 04/06/18

21 04/02/18 - 04/15/18 04/13/18 04/20/18

22 04/16/18 - 04/29/18 04/27/18 05/04/18

23 04/30/18 -05/13/18 05/11/18 05/18/18

*24 05/14/18 - 05/27/18 Noon 05/24/18 06/01/18

25 05/28/18 - 06/10/18 06/08/18 06/15/18

26 06/18/18 - 06/24/18 06/22/18 06/29/18

* Designates Early Payroll

BI-WEEKLY CASUAL PAYROLL 2017 - 2018

Direct deposit instructions:

1. To enroll in Direct Deposit, please visit http://my.columbia.edu.

2. Log in using your UNI and UNI password.

3. Click on the Faculty & Staff tab at the top.

4. Under Faculty and Staff Self-Service, click on the link to "View

your Direct Deposit Information".

5. Please have your routing and account number handy.

6. If you are direct depositing into one account, select “Add Account” A. From the dropdown menu, select your account type

B. Deposit type is "Percent" C. Amount or Percent is “100” D. Deposit order is "1"