To:	Arnett Mace

From:	(Department Head)

Date:	(Today’s date – must be in time to receive BOR approval prior to payment)

Subject: Employment of Retired Faculty

This is to request authorization to employ     Name                                               , social security number XXX-XX-XXXX, as a      Title                        for the period of Begin date - end date      . The total budget and EFT for this employment period will be $Amount   and   EFT        . 

  Name                                             is a retiree of the University System. A completed copy of The University of Georgia Payment to Individual Retired from the University System is attached.

If this request meets with your approval, I ask that you forward the information to the Chancellor for Board of Regents approval.

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Associate Dean                             Date

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VPI                                                Date