After completing, please print and deliver to HR for new employees, or to Computing Services for changes to current employees.
Required fields
Supervisors, please ensure ALL information is filled out. Failure to do so may result in delays in processing. Some services require 24–48 hours to go into effect.
Supervisors, please select any/all systems to be used by the employee and have the appropriate Data Owners sign.
Supervisors, please do not write in this area.
When the print dialog opens, choose Save as PDF as the destination.