WAIVER OF PAYMENT

(Please complete all areas labeled with green text, as shown on your pc screen.)

I, (print your name)
understand and agree that I have voluntarily waived payment for my duties as:
Title/Rank:	Banner ID:
With the (dept) of:
In the School/College of: of:
For the Period of:	(term/date)

(term/date)
Through:	(term/date)

(term/date)
During the school year: year: year
I further understand and agree that I will not be eligible to receive unemployment compensation or any other benefits of employment at SIUE. I understand that this waiver and agreement is binding forever upon myself, my heirs and successors.

Employee's Signature:

Date:

8/03

WAIVER OF PAYMENT

SIUE

2009-01-20

OIT

SIUE