This is a smart form.

Most information such as rates and budget codes populate automatically based on the information you provide.

However, if you are completing this form for additional pay that is not built-in, please reach out to your campus manager first to obtain rate and budget code information prior to beginning this form.

If there is a form error, please refresh the page to begin again.

I hereby certify that I performed the above duty as assigned. I understand that it is my responsibility to obtain, complete, and return this form to my office manager in a timely manner as to allow processing time for the routing of all required signatures. I also recognize that if this form is received after the specified payroll cut-off date, this will be paid on the following payroll cycle. Finally, I understand that it is against district policy to obtain income from two different sources during the same performance period.