Pay Notice — Workers Paid Weekly Rate or Salary for Fixed Hours — UB Foundation (UBF)

An acknowledgement of pay rate and payday for employees paid a weekly rate or a salary for a fixed number of hours (40 or fewer in a week). This is for use with UB and RF faculty and staff who are funded with UBF resources.

Download the Form

UBF Pay Notice–Workers Paid a Weekly Rate or Salary for a Fixed Number of Hours
Mobile Users

For the best experience in completing this form use a non-mobile device.

Using Firefox with PDF forms?

Make Adobe Acrobat the reader.

Completing the PDF Form

  1. Read through all pages of the document to find specific instructions
  2. Enter requested information into the form
  3. Print the form
  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original form to the appropriate address:

Campus Mail

UB Foundation Human Resources
103 Center for Tomorrow
North Campus

External Mail (USPS)

UB Foundation Human Resources
P.O. Box 900
Buffalo, NY 14226-0900

Need Help Completing the Form?

Rebecca Broderick.

Rebecca Broderick

Payroll Accountant

UB Foundation

Phone: 716-645-8734

Email: rlbroder@buffalo.edu

Vanessa Phengsomphane.

Vanessa Phengsomphane

Payroll Accountant

UB Foundation

Phone: 716-645-8732

Email: vlphengs@buffalo.edu

Katie D’Amato.

Katie D’Amato

Payroll Manager

UB Foundation

Phone: (716) 645-8735

Email: kdamato@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: 3/2011

Owner: UB Foundation