Cape Girardeau Public School District No. 63

Cape Girardeau Public School District No. 63

Semi-Monthly Pay Check Election Form

Hourly employees hired before July 1, 2011 currently receiving a monthly pay check for time worked may elect to begin receiving semi-monthly pay checks. Employees working less than 12 months will receive their pay in 22 pay checks over 11 months. The payments will begin in the month of August and run through June.

First Name______M.I.______Last Name______

Building/Department: ______Phone: ______

Select election options:

9-11 month employee

·  I currently work less than 12 months and understand that I will receive 22 pay checks from August to June; and will not receive a pay check for July.

·  I understand that my pay dates will be on or before the 15th and 30th of each month, beginning in August and ending in June (according to the district payroll calendar).

·  I understand that I may be contacted by the Benefits Department to discuss my current payroll deductions should my election have an effect on the current amount withheld.

12 month employee

·  I currently work 12 months and understand that I will receive 24 pay checks from July to June.

·  I understand that my pay dates will be on or before the 15th and 30th of each month (according to the district payroll calendar

·  I understand that I may be contacted by the Benefits Department to discuss my current payroll deductions should my election have an effect on the current amount withheld.

I hereby authorize my employer to begin paying me over the semi-monthly pay schedule I am eligible for. By signing below, I acknowledge and understand that this election will continue throughout my employment with the Cape Girardeau Public School District. I further acknowledge and understand that the only action that would change my election would be a change in position that would require pay period cycle that differs from the one marked above.

Signature______Date ______