Praire View A&M University - Save for Summer Authorization

This form allows employees who work less than 12 months a year to extend their pay over a full 12 months. Employees may also use this form to cancel their enrollment in the Save for Summer plan.

Privacy Notice: State law requires that you be informed that you are entitled to:(1) request to be informed collected about yourself on this form (with a few exceptions provided by law); (2) receive and review that information; and (3) have the information corrected at no charge.
Options*field type radio button
OptionsEnrollmentCancellation
UIN*field type number
Make sure you are entering your UIN correctly
Last Name*field type single line
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First Name*field type single line
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PVAMU Email*field type email

Enrollment

Deduction Amountfield type currency
I authorize Prairie View A&M University to reduce the net amount of my paycheck by the amount shown above, for each of the nine months of September through May. I authorize Prairie View A&M University to hold these funds for the purpose of distributing the balance to me in three equal payments in June, July and August. I understand that participation in this plan is not an extension of my employment contract.
I understand that having an employment period of less than twelve months is a requirement for my participation in the Plan. I understand that all deductions and federal income tax withholding will be taken on a monthly basis when earned. I recognize my participation in the Plan begins with the first available monthly pay date after I file a properly completed enrollment form with my payroll office, and there are no catch-up provisions for ant expired portion of the fiscal year.
I understand that I will not receive any interest earnings for these funds.
I understand that I may stop my participation at any time, and may elect to receive disbursement on the next available monthly pay date. I recognize that following cancellation, I may not participate in the Plan again until the next fiscal year.
Signaturefield type signature

Cancellation

I understand that I may stop my participation at any time, and may elect to receive disbursement on the next available monthly pay date. I recognize that following cancellation, I may not participate in the Plan again until the next fiscal year.
Payment Methodfield type radio button
Refund will be processed via regular payroll method as selected in Workday.
Payment Method
Signaturefield type signature