/ Casual Claim Form FOR ACADEMIC STAFF ONLY
PLEASE USE BLUE OR BLACK PEN ONLY

Deadline for receiving claims is 5.00pm on the Thursday prior to a pay week. Return completed form to HR Service Centre, Level 2. The Box Factory K06, 1 Ross Street, Glebe

The following are REQUIRED for Processing of Payment. If these fields are not filled in, there will be a delay in payment processing.

Employee ID No: ______Job Record No: _____ Surname: ______First name: ______Middle name: ______

Ext: ______FACULTY: ______Dept/School/Unit: ______

PLEASE NOTE:

  1. Staff will not be paid if Earnings Codes are not stated on this form.
  2. Use this column where the Earnings Code relates to payment for more than one hour, eg, casual lecturing, PO2, includes 1 hour of delivery and 3 hours of associated work time. This is ONE unit

Day / Date / Earnings Code / Rate
(Only for use with PLT Earnings Code) /
Units Claimed
See Note 2 / Hours Worked / Start Time / End Time / Description of Duties Performed (Employee to fill out) / Account to be charged
(If this has changed since the last claim form).
R/C / P/C /

Analysis Code

Total
Signature of Employee: Date: ______/ ______/ ______
(Must be completed for payment to be authorised)
Supervisor’s Authorisation (Must be completed for payment)
I certify that the staff member has worked the hours detailed above and that the minimum casual hours requirements have been complied with. / Head/Delegated Officer Authorisation (Must be completed for payment)
I authorise payment for this work from the nominated account.
Name: Ext.: ______/ Name: Ext.: ______
Signature: Date: _____ / _____ / ______ / Signature: Date: _____ / _____ / ______
HR Service Centre Use Only:
Entered By: ………………………..………… ……… Date: ….. / …… / …………. Checked By: ………. ……………………………... Date: ….. / …… / ………….