You are on page 1of 1

Saint Peter Public Schools

Payroll/Personnel Information
Fill in the fields with the appropriate information:
TO BE COMPLETED BY EMPLOYEE
Name
Address
City, State, Zip
Phone
Position
Social Security #
E-mail Address
Birthdate
Spouses Name
Are you Hispanic/Latino?
What is your race?
(Choose one or more)

Yes

No

Retirement

American Indian or Alaska Native

Current TRA #

Asian

Folder #

Black or African American

Current PERA #

Native Hawaiian or other Pacific Islander

None

White

Signature:________________________________________________

Date-_________________

TO BE COMPLETED BY PRINCIPAL:
Job Title

New Position:

Building

Yes

No

Start Date

Hours/Day

Rate/Hour

If No, who is being replaced?

Signature-________________________________________________
(Principal)

Date-________________

Attach the following completed forms and copies:


W4
I-9
(Employment Eligibility Verification)
ACH Direct Deposit of Payroll
Background Check Form
Copy of Teaching License (if applicable)
Current College Transcript (teachers and administrators only)
Send completed form to District Office. Payroll checks cannot be processed until this information is on file.
District Office Use only:
Employee # __________________________

Payroll Start Date: _________________________

You might also like