Pay Option Change Consent Form
State 10-month faculty submit this form consenting to change from a 21-pay period paycheck to a 26-pay period paycheck.
Submit to your department head no later than June 30.
Download the Form
Completing the PDF Form
- Print the form
- Complete requested information
- Sign form
- Scan a copy of the signed form for your records
- Send the original, completed, signed form to your department head by June 30
Need Help Completing the Form?
Send email, phone or submit a question
Changing the Pay Option
Leave or Benefit Coverage
Payroll Questions
Dana Moore
Manager
State Payroll and Appointment Processing
Phone: 716-645-8157
Email: dlmoore@buffalo.edu
About the Issue or Your Comments
Form Facts
Form Type: Downloadable, PDF document
Requirements: Adobe Reader
Updated: 4/2017
Owner: Human Resources