ࡱ>  bjbj00 CZgZg@B^^8<D6D "("""&v ',8'6666666$8;*6P'&&P'P'*6""?6+++P'^""4p+P'6++:0, 1"^'0 4U6060R3<0(3< 13< 1`P'P'+P'P'P'P'P'*6*6)P'P'P'6P'P'P'P'3<P'P'P'P'P'P'P'P'P'^X :  APPLICATION FOR BANNER HR ACCESS  Use this form to request access to the Banner Human Resource and Payroll system. Applicant Responsibilities Access is restricted to University employees performing official duties of their position. Comply with the Universitys policy on Responsible Use of Information Technology (HYPERLINK "http://www.utoledo.edu/policy/index.asp?id=45"http://www.utoledo.edu/policy/index.asp?id=68). Comply with the Family Education Rights and Privacy Act (FERPA) (HYPERLINK "http://www.utoledo.edu/policy/index.asp?id=45"http://www.utoledo.edu/policy/index.asp?id=45). Please contact the Registrars Office for FERPA related questions. Instructions Complete the Applicant Information section on page one below. Page two will be completed by the Data Custodian. Obtain supervisor approval. Send completed form to Human Resources, MS 205. Questions can be directed to Mark Halsey: Mark.Halsey@utoledo.edu Applicant Information: Name (Last, First, Middle Initial): Title/Position: College/Department:Rocket ID:UTAD ID: Mail Stop:Phone #: Employment Status: FORMCHECKBOX  Faculty  FORMCHECKBOX  Staff  FORMCHECKBOX  Graduate Assistant  FORMCHECKBOX  Student Assistant Access Requested: FORMCHECKBOX  New no current access  FORMCHECKBOX  Remove Access  FORMCHECKBOX  Add additional access requested  FORMCHECKBOX  Transfer remove old and add new access Module:  FORMCHECKBOX  Human Resources and Payroll  FORMCHECKBOX  E print Reports for HR/Payroll Module Reason for access: User Signature & Date: (Signature indicates acceptance of applicant responsibilities)Supervisor Approval:Print Name:Title/Position:Signature & Date:Phone #: APPLICATION FOR BANNER ACCESS (Continued) Applicant Information: Name (Last, First, Middle Initial): To be completed by Data Custodian check all appropriate security classes: Human Resources and Payroll 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Desk FORMCHECKBOX  General Accounting Data Entry  FORMCHECKBOX  Payroll Manager FORMCHECKBOX  Grants Accounting Analyst  FORMCHECKBOX  Payroll Officer  FORMCHECKBOX  Grants Accounting Manager  FORMCHECKBOX  See/Search SSN FORMCHECKBOX  Grad Assist Admin FORMCHECKBOX  Staff Labor Relations Admin FORMCHECKBOX  Grad Assist Manager FORMCHECKBOX  Staff Labor Relations Manager FORMCHECKBOX  Health and Safety Admin FORMCHECKBOX  Student Employment Admin FORMCHECKBOX  Benefits Inquiries FORMCHECKBOX  Student Employment Manager FORMCHECKBOX  HR Front Desk FORMCHECKBOX  Systems Analyst - HR Human Resources Office (Data Custodian) approval:Signature & Date: Payroll Office (Data Custodian) approval (shaded areas) if applicable:Signature & Date: *** Faculty HR Admin & Faculty HR Manager classes are approved only by : Brenda Grant MS 939 (Main Campus) Signature & Date: To be completed by IT Security Administrator:Signature & Date:     Form Version 1.3 Page  PAGE 2 of  NUMPAGES 2 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