NOTE:

Submit a hard copy of this form to Human Resources(309 Administration Building) for a payment that meets the following criteria:

  1. The person was a U of M Employee during the time of the service/Guest Lecture/honorarium/award
  2. AND The payment is for one of the following: (Definitions on page 2)
  3. Fee for a Non-Employment Related Service For guidelines on the four tests of employment, click the link
  4. Honorarium Tests of Employment
  5. Prize/Staff Award:
  6. Guest Lecturer/Speaker Payment

NOTE: The amount must be payable to the employee as an individualnotto a company. If you are paying a business, go to (insert link) and say ‘no’ to the question ‘is this person an employee?’ After that answer the questions and the process flow will take you to the correct form or system.

Questions? Click link for Contact:

1. Personal Information
Note:Enter the legal name (as given on the Social Insurance card) in the Surname, First Name, and Middle Name(s) fields. If the name normally used is not the legal first name, also enter Name Normally Used.
Salutation: / Mr. / Mrs. / Ms / Miss / Dr. / other (specify):
SURNAME: / U of M Employee No:
First Name:
Middle Name:
Name Normally Used:
NOTE:
If you are collecting the above information from the employee verbally, you must read the following FIPPA statement aloud to the employee:
FIPPA Statement
This personal information is being collected under the authority of the University of Manitoba Act and will be used to maintain a record of personnel paid through the University Human Resources Information System and other systems, to make reimbursement, and to issue income tax receipts to those personnel. It is protected by the Protection of Privacy provisions of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, contact the FIPPA Coordinator’s Office (204) 474-8339, c/o Archives and Special Collections, 331Dafoe Library, University of Manitoba, R3T 2N2.
2. Deliverable/Services Details
Reason for Payment: / Guest Lecturer / Non-Employment Service / Prize Award / Honorarium
Position Number (if known): / Faculty or Unit:
Department: / Section (if applicable.):
Start date: / GL Account:
End Date (for services & Guest Lecturers): / AURORA / F / O / P / %
AURORA / F / O / P / %
Total amount payable:
If Service or Guest Lecture(s): Approximate number of hours to complete work:
Province in which deliverable/service(s) provided:
Description of service provided (be as detailed as possible):
Key Duties:
I certify that the information provided on this form is correct and that the work described above has been completed satisfactorily.
Signing authority on the account(s): / Date:
Department Head Approval (Optional) / Date:
This form prepared by: / Name: / Phone: / Date:
Additional comments:
Attachments: / Other (specify)

Definitions

Fee for a Non-Employment Related ServiceServices provided that do not constitute employment with the University of Manitoba. These services must not be work that is covered under an existing collective agreement (eg. Administrative work, Custodial services, etc.), or be part of the core business of the University (eg. Teaching, Research)

Examples of non-employment services include: research subjects (experimental subjects), Preceptors (in the Faculty of Medicine), Invigilators where the exam is not being offered at a U of M site and the invigilator is chosen by the other institution (such as a principal at a high school).

NOTE: if you are not sure if the service should be employment, see the test of employment and/or contact your HR Consultant.

HonorariumA voluntary (non-negotiated) payment that is given to a person for services for which fees are not legally or traditionally required. Honoraria are typically used to help cover costs for volunteers.

Prize/Staff Award: The criteria for awarding the prize or award must be such that a recipient is rewarded for success in an area in which the recipient regularly applies effort. An amount qualifies as a prize or award if it is paid in recognition of genuine accomplishment in a challenging area, whether it be of an academic, vocational, or technical nature. No services can be rendered for the award. Prizes and awards can be made to either faculty members or students. When given to a faculty member or employee, the award must not relate to employment-related achievements such as awards for long service, innovation, excellence, or suggestions.

Guest Lecturer/Speaker Payment – A person brought in for a limited duration to lecture in an area where they have expertise and have not been selected and hired from a pool of applicants. The guest lecturer/speaker has no ongoing responsibility to the participants or students attending and is not responsible for marking or grading. Also, the University does not control the content of the lecture other than the topic.

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