GRADUATE STUDENT DEDUCTION AUTHORIZATION

Full Payroll Deduction Policy available at www.mun.ca/regoff/comtroller/GradStudDedAuthPolicy.html

 

Name ____________________________________

Social Insurance Number _____________________

Department ________________________

Student Number: ____________________

 

 

FALL ______

 

WINTER ______

 

SPRING ______

Tuition Fees

____________________

____________________

____________________

Burtons Pond Apartments

____________________

 

____________________

 

____________________

GSU Fees

____________________

 

____________________

 

____________________

Foreign Health Insurance

____________________

 

____________________

 

____________________

Dental Plan

____________________

 

____________________

 

____________________

Health Plan (Canadian)

____________________

 

____________________

 

____________________

Recreation Fee

____________________

 

____________________

 

____________________

Total

$___________________

$___________________

$___________________


To be Completed by the Cashier's Office:

Number of Deduction Periods

   

   

   

Bi-weekly Deduction Amount

   

   

   

DEDUCTION AUTHORIZATION:

I hereby authorize Human Resources to deduct from my Fellowship/Bursary bi-weekly deductions of $______ for the Fall Semester, $______ for the Winter Semester and bi-weekly deductions of $______ for the Spring Semester. Should the tuition fee structure change, the amount of my deduction will change accordingly. Deductions will commence on the second pay period of each semester if this authorization has been completed prior to the commencement of the semester.

I accept responsibility to notify the Cashier's Office should additional charges for emergency loans, library fines, penalties, etc., be incurred in order to adjust my payment schedule. 

Student Signature _______________________________ Date _____________________
Copies 1-3 Human Resources 4 - Cashiers Office 5 - Student