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?
Leave or Benefit Coverage
Payroll Questions
Dana Moore
Manager
State Payroll and Appointment Processing
Phone: 716-645-8157
Email: dlmoore@buffalo.edu
Form Facts
Form Type: Downloadable, PDF document
Requirements: Adobe Reader
Updated: 3/2020
Owner: Human Resources