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EMPLOYEE REFERRAL PAYOUT FORM

The following employee is eligible to receive a referral bonus for recruiting a full-time or hourly/temporary employee:
Employee's Name:
SSN:
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Any changes will overwrite saved masked data
Dept./Company:
 
Referred Employee:
Hire Date:
Dept./Company:
Supervisor:

 

Amount of Bonus:
 $100 net for full-time employee
 $50 net for part-time or temporary employee

 

Approximate Date of Bonus Payment*:
Full time:
(minimum 90 days from hire date)
Hourly or Temporary:

(minimum 30 days from hire date)
*payment will be made to the referring employee on the next payroll date following eligibility.
Dept./company to be charged:
**Supervisor Approval:
Supervisor of referred employee
Date
**Note to Supervisor:   If the referred employee does not complete the introductory period, meet the minimum days of service, or does not meet acceptable performance standards, please contact Payroll to cancel this referral payment.

 

For Payroll Use
Date received:
Gross Amount $
Bonus payment paid on payroll ending
Intracompany charged to:
Completed by: