Use this form to request access to the Banner Human Resource and Payroll system.
Applicant Responsibilities
- Access is restricted to University employees performing official duties of their position.
- Comply with the University’s policy on Responsible Use of Information Technology (
- Comply with the Family Education Rights and Privacy Act (FERPA) ( Please contact the Registrar’s Office for FERPA related questions.
Instructions
- Complete the Applicant Information section on page one below. Page two will be completed by the Data Custodian.
- Obtain supervisor approval.
- Send completed form to Human Resources & Talent Development, MS 405. Questions can be directed to Kelley Guldenpfennig:
Applicant Information:
Name (Last, First, Middle Initial):
Title/Position:
College/Department:
Rocket ID: / UTAD ID:
Mail Stop: / Phone #:
Employment Status: / Faculty Staff Graduate Assistant
Student Assistant
Access Requested: / New – no current access Remove Access
Add – additional access requested
Transfer – remove old and add new access
Module:
Human Resources and Payroll Eprint Reports for HR/Payroll Module
Reason for access:
User Signature & Date:
(Signature indicates acceptance of applicant responsibilities)
Supervisor Approval:
Print Name:
Title/Position:
Signature & Date:
Phone #:
APPLICATION FOR BANNER ACCESS
(Continued)
Applicant Information:Name (Last, First, Middle Initial):
To be completed by Data Custodian – check all appropriate security classes:
Human Resources and Payroll Security Classes
Affiliate Entry / Health and Safety Manager
Benefits Analyst / HR General Forms
Benefits Director / HR General Inquiries
Benefits Specialist / Office Maintenance
Budget Office / Payroll Analyst
EEO Affirmative Action Admin / Payroll Clerk
EEO Affirmative Action Manager / Payroll Clerical Specialist
Employment Comp Admin / Payroll Data Entry AP
Employment Comp Manager / Payroll Effort Certification
Faculty HR Admin *** Please see below / Payroll EPAF Admin
Faculty HR Manager *** Please see below / Payroll Fringe Detail Eprint
Faculty Labor Relations Admin / Payroll Front Desk
Faculty Labor Relations Manager / Payroll Manager
General Accounting Data Entry / Payroll Officer
Grants Accounting Analyst / Payroll Setup Rules
Grants Accounting Manager / See/Search SSN
Grad Assist Admin / Staff Labor Relations Admin
Grad Assist Manager / Staff Labor Relations Manager
Health and Safety Admin / Student Employment Admin
Benefits Inquiries / Student Employment Manager
HR Front Desk / Systems Analyst - HR
Human Resources Office(Data Custodian) approval:
Signature & Date:
Payroll Office (Data Custodian) approval (shaded areas) if applicable:
Signature & Date:
*** Faculty HR Admin & Faculty HR Manager classes are approved only by :
Brenda Grant MS 939 (Main Campus) ~ or ~ Bryan Pyles MS 1018 (Health Science)
Signature & Date:
To be completed by ITSecurity Administrator:
Signature & Date:
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