I Confirm That I Have Alerted the Above-Named Casual Staff Member to the Option of Conversion

/ CASUAL EMPLOYMENT EXTENSION FORM (Professional Staff)
(HR/PSE) effective 04/14
1This form is to be used to extend an existing period of casual employment and should be forwarded to Payroll Services in advance of the cessation of the original term of casual employment to avoid delays in payment.
2For administrative purposes, and irrespective of the envisaged duration of the extension, the job details specified below will remain valid on the HR system for a period of 12months from commencement.
3Supervisors are reminded that casual staff may apply to have their employment converted to a non-casual appointment under certain conditions and that they should be informed of this from time to time (see / Payroll Use Only
Job No
Payroll No
Position No
PART A – DETAILS OF EMPLOYEE
Title: / Family Name: / Given Names: / Payroll No: / Job No:
Faculty / Portfolio: / School / Division:
Unit / Discipline: / Located at (ie Bedford Park, FMC, Noarlunga etc):
State (where work is performed):
SA NT WA QLD NSW ACT VIC TAS Other:
Visa Restrictions- this section must be completed
Does staff member hold a visa?
YES / NOYESNO / If yes, indicate type and sub-class / What work rights are attached to the visa?
Important: If the casual employee currently has a Visa, please scan and email a copy of the Visa (plus passport photograph page) to so that HR can verify the employee’s work rights. NB Breaches of immigration regulations attract heavy financial penalties.
PART B – DETAILS OF EXTENSION
Extension Start Date: / Extension Estimated End Date: / Classification: / Casual Rate:
//20 / //20 / HEO / $ per hour
Salary Account Number(s) to be Charged:
Account Fraction / %
Account Fraction / %
Reasons for the Proposed Extension:
PART C – AUTHORISATION
Supervisor

I confirm that I have alerted the above-named casual staff member to the option of conversion to a non-casual appointment (see note 3 above).
I confirm that the existing arrangements for electronic timesheet approval for this employee are to remain for this extension period.

Supervisor’s Signature: / Print Name: / Date:
Dean of School / Head of Division (orDelegate)

I approve the request to extend the casual employment of the staff member mentioned above and confirm that there are sufficient funds (including on-costs) to support this extension.
I acknowledge that the nominated Electronic Timesheet Approver will approve electronic timesheets on the Employee Self Service for this casual employee.

Dean of School / Head of Division Signature: / Print Name: / Date:

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