UNIVERSITY OF VIRGINIA
          FINANCIAL AND ADMINISTRATIVE PROCEDURES MANUAL



TITLE:  PREPARATION OF DESIGNATION FOR            PROCEDURE:  4-36
        INDIVIDUAL PAYCHECK PICKUP                                 
                                                                   

Policy Reference:              

See also Procedure:            4-31, "Duties and Responsibilities
                               of Payroll Distribution Officers"

Form:                          Designation for Individual Paycheck
                               Pickup (UT-180)

Obtain Blank Forms From:       University Bursar's Office, Check
                               Distribution Section, Carruthers
                               Hall, 924-4459.

Forward Completed Forms To:    Departmental Payroll Distribution
                               Officer.

Purpose

To authorize Departmental Payroll Distribution Officer to release
employee's paycheck to a third party.

NOTE:  The Payroll Distribution Officer is responsible for seeing
that this form is complete and signed by the employee.  If there is
a doubt whether the employee completed this form, the Distribution
Officer should contact the employee before releasing his/her check.

NOTE:  Checks for deceased employees are classified as unclaimed
checks and must be returned to the Bursar's Office.  Please attach
a note of explanation. See also Procedure 4-32, "Processing
Unclaimed Payroll Checks."

This form is to be kept on file in the department.  The Bursar's
Office does not maintain a file for this form.  Retain the form
according to Policy II.C.1 and Procedures 2-30, 2-31, and 2-32.

Instructions

The numbered items on the sample form should be completed as
follows:

     Completed by Employee

 1.  Employee's typed or printed name.

 2.  Employee's department name.

 3.  Employee's social security number.

 4.  Three letter Home Department Code representing employee's
     department.                                                   

 5.  Current date.

 6.  Type of pay period.

 7.  Employee's position.

 8.  Paydates for which the employee is requesting a third party to
     pickup his/her paycheck.

 9.  Employee's signature.

     Completed by Designated Individual

10.  Name of third party who will pick up employee's check.

11.  Third party's department if a University employee; otherwise
     leave blank.

12.  Third party's social security number.

13.  Third party's position if a University employee; otherwise,
     leave blank.

14.  Third party's relationship to employee.

15.  Employee has third party sign the form.

     Completed by Departmental Payroll Distribution Officer

16.  His/her name.

17.  His/her position.

18.  Date of paycheck(s) to be distributed.

19.  Notes that third party's name and social security number match
     (10) and (12) above.

20.  Writes what form of PHOTO identification was presented by
     third party.

21.  Includes any other pertinent information needed.


22.  Has third party sign full name on Check Receipt List next to
     employee's name and notes this is a third party picking up the
     check.


Disposition

Original and 
Yellow Copy  --  File in permanent departmental file. 

Pink Copy    --  To employee.


                                                                   
ISSUED BY:                                                 07/17/89

University Bursar             4.36.3