REQUIRED - Texas A&M University-Corpus Christihr.tamucc.edu/assets/Employment Packet...

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(3/13) Attached is the employment packet you must complete and turn in to your department liaison. This is an essential step in processing payroll and an incomplete employment packet will most likely result in a delay in processing a paycheck for you. All questions concerning employment and/or employment documents should be directed to your supervisor. Below are links to information that you are responsible for knowing. Please read these carefully and view them carefully. 1. Protected Veteran Status Criteria 2. Student FICA Exemption 3. Employee Acknowledgement Form (Employee Copy) 4. Instructions on Setting Up REQUIRED Direct Deposit Make sure you print, sign and date all forms. Please send your packet to the department that hired you.

Transcript of REQUIRED - Texas A&M University-Corpus Christihr.tamucc.edu/assets/Employment Packet...

Page 1: REQUIRED - Texas A&M University-Corpus Christihr.tamucc.edu/assets/Employment Packet 2013.pdfAttached is the employment packet you must complete and turn in to your department liaison.

                  (3/13) 

Attached  is  the  employment  packet  you must  complete  and 

turn  in to your department  liaison.   This  is an essential step  in 

processing payroll and an  incomplete employment packet will 

most  likely  result  in a delay  in processing a paycheck  for you.   

All  questions  concerning  employment  and/or  employment 

documents should be directed to your supervisor. 

Below  are  links  to  information  that  you  are  responsible  for 

knowing. Please read these carefully and view them carefully. 

1. Protected Veteran Status Criteria 

2. Student FICA Exemption 

3. Employee Acknowledgement Form (Employee Copy) 

4. Instructions on Setting Up REQUIRED Direct Deposit 

 

Make sure you print, sign and date all forms. 

Please send your packet to the department that hired you. 

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Texas A&M University-Corpus Christi

Criminal Background Check Authorization

With few exceptions, you have the right to request, receive, review and correct information about yourself collected using this form.

Candidate/Applicant/ Interviewee Job:_________________________________________ Contractor Volunteer Other: _________________ For:______________________ Employee _____________________ ___________________ ________________ Job Title Department Date of Hire

An Equal Opportunity/Affirmative Action Employer Texas A&M University-Corpus Christi does not discriminate on any basis prohibited by applicable law including race, color, religion, sex, national origin, disability, age, citizenship status, or veteran’s status in recruitment, employment, promotion, compensation, benefits or training. The information on this form is the property of Texas A&M University-Corpus Christi.

To be completed by the applicant/employee: Provide all information requested and deliver or fax this form to Human Resources at (361) 825-5871.

Provide name as it appears on Social Security card.

_________________________ ________________________ ________ __________ Last Name First Name Middle Initial UIN/SSN

_________________________ ______________________________ _________ Address: Number and Street City, State & Zip Code Race

_______ ____________ _________________ _________ Sex Date of Birth Driver’s License Number Issuing State Please list all places of residence since the age of 18. Include City, State, County and Country. Attach extra pages if needed. _____________________________________________________________________________________________ _____________________________________________________________________________________________ ____________________________________________________________________________________________ Former Names Used: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Texas A&M University-Corpus Christi may obtain background information, including criminal history record, Selective Service registration and degree verification at any time during my application process and/or employment. I understand this information will be used only for evaluation for employment or continued employment with Texas A&M University-Corpus Christi. I hereby authorize the Texas Department of Public Safety or any other entity authorized to access state or federal agency records to furnish Texas A&M University-Corpus Christi, or its agent, my background records. I do hereby release all agents, servants, and employees of Texas A&M University-Corpus Christi, the person in charge of any law enforcement agency or department and all members of such law enforcement agency or department from all liability resulting from the release of this information.

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The following are my responses to questions about my criminal history, if any. (Exclude minor traffic offenses punishable only by fine.) Yes No

Have you ever been convicted or pled guilty before a court for any federal, state or municipal criminal offense?

Have you ever received deferred adjudication or similar disposition for any federal, state or municipal offense?

Have you ever received pretrial diversion or similar disposition for any federal, state or municipal offense?

Have you ever received probation or community supervision for any federal, state or municipal offense?

Have you been convicted of any criminal offense in a country outside the jurisdiction of the United States?

As of the date of this consent form, do you have any pending charges against you?

If you answered yes to any of these questions, please provide details below. Attach extra pages if needed.

State_____ County:_______________ Date of Offense:__________________________ (MM/DD/YY) Details: _____________________________________________________________________________________________

State_____ County:_______________ Date of Offense:__________________________ (MM/DD/YY) Details: _____________________________________________________________________________________________ I acknowledge that a facsimile or copy of this document shall have the same validity, force and effect as the original. System Regulation 33.99.14 addresses the operation of criminal history background checks within the A&M System, including appeal procedures. The Texas A&M University System regulations require that an employee must report to his/her supervisor any criminal arrests, criminal charges, or criminal convictions, excluding misdemeanor traffic offenses punishable only by fine, within 24 hours or at the earliest possible opportunity. Failure to report shall constitute grounds for disciplinary action, up to and including termination. The employee’s supervisor must report the arrest(s), criminal charge(s), or conviction(s) to both the head of the department/unit and the Human Resources Office. If you have questions, please contact Human Resources at (361) 825-2630. I hereby certify that all information provided by me on this form is true, complete, and correct. I understand that any false statements made herein may void my application for employment, be grounds for termination of my current employment and affect my eligibility for future Texas A&M University-Corpus Christi employment. __________________________________________________ ____________________ Applicant/Employee Signature Date

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DPS Computerized Criminal History (CCH) Verification  

(AGENCY COPY)   

I, , have been notified that a Computerized Criminal APPLICANT or EMPLOYEE NAME (Please print)

History (CCH) verification check will be performed by accessing the Texas Department of Public Safety  

Secure Website and will be based on name and DOB identifiers I supply.  

Because the name-based information is not an exact search and only fingerprint record searches

represent true identification to criminal history, the organization conducting the criminal history check

for background screening is not allowed to discuss any criminal history record information obtained

using the name and DOB method. Therefore, the agency may request that I have a fingerprint search

performed to clear any misidentification based on the result of the name and DOB search.

For the fingerprinting process I will be required to submit a full and complete set of my

fingerprints for analysis through the Texas Department of Public Safety AFIS (Automated Fingerprint

Identification System). I have been made aware that in order to complete this process I must make an

appointment with L1 Enrollment Services, submit a full and complete set of my fingerprints, request a

copy be sent to the agency listed below, and pay a fee of $24.95 to the fingerprinting services company,

L1 Enrollment Services.

Once this process is completed and the agency receives the data from DPS, the information on

my fingerprint criminal history record may be discussed with me.

 (This copy must remain on file by your agency. Required for future DPS Audits)

    Signature of Applicant or Employee  

Please: Check and Initial each Applicable Space

 

Date  

     Texas A&M University – Corpus Christi Police Agency Name (Please print)

   Agency Representative Name (UPD officer)

Signature of Agency Representative (UPD officer) 

Date

CCH Report Printed:  YES NO initial  Purpose of CCH:  Hire Not Hired initial

Date Printed: initial

Destroyed Date: initial

Retain in your files   

Rev. 02/2011

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The Texas A&M University SystemEmployee Personal Data

With few exceptions, you have the right to request, receive, review and correct information about yourself collected using this form.

Name: __________________________________ __________________________ _______________________________ Last First Middle

UIN or SSN: ______________________________ Birthdate: ______________________________ Month Day Year

Citizenship: ______________________________ Visa type: ______________________________ Country If other than U.S. citizenship

�Male Highest � 1–Less than high school � 2–High school/GED � 3–Associate degree� Female Education � 4–Baccalaureate degree � 5–Master’s degree � 6–Doctoral degree

Level � 7–Special professional (D.D.S., D.V.M., J.D., M.D., etc.) _____________________________You are not obliged to respond to the asterisked items below (Veteran and Former Foster Child Status) and on Page 3; however,your response is important to meet federal and state reporting requirements. Any information you provide will remain confidentialin accordance with applicable federal and state regulations. Your employment will not be adversely affected by any information youfurnish.

Residence address Mailing addressStreet: _________________________________________ Street/P.O. Box: ______________________________________

City: __________________ State: ____ ZIP: ___________ City: ________________________ State: ____ ZIP: _________

Phone: ( ) Phone: ( )In event of emergency notify: Do you have relatives who are A&M System employees?

Name: _______________________________________ �� Yes � No

Relationship: __________________________________ If yes, give name, title, relationship and organization:

Address: _____________________________________ __________________________________________________

City and state: ________________________________ __________________________________________________

Phone: ______________________________________ __________________________________________________

State law gives you the right to choose whether The Texas A&M University System should allow public access to your homeaddress, home telephone number, Social Security number, and whether you have family members. If you do not declare thispersonal information as confidential, it will be open to the public. If you are a “peace officer,” your home address and telephonenumber are automatically confidential. Mark one box in item 1 and one box in item 2.1. � Yes, I want my personal information to be confidential. � No, I do not want my personal information to be confidential.2. � I am a certified peace officer. � I am not a certified peace officer.

Employer should complete the following for employee:PIN: ____________________________ Employee location code: ____________________________

ADLOC: _________________________ Check distribution code: ____________________________

Campus or office address:

___________________________________________

___________________________________________ Mail Stop: _________ Office phone: _______________________

HR 181 (11/09)Check one:___ TRS ___ ORP

Please read and sign Pages 2 and 3 of this form before returning it.

1

EEO Ethnicity/Race (See Page 2) *Veteran Status (See Page 2. Check all that apply.) 3-Hispanic or Latino? � Yes If you selected ‘Yes,” you � Veteran

will be identified as Hispanic or Latino for federal and � Armed Forces Service Medal Veteran and state reporting purposes, even if you select any of � Other Protected Veteran the races below. � Recently Separated Veteran (within last three years)-If yes,Select all that apply. indicate armed services separation date ________________� 1–White � 2–Black or African American � Orphan of a Veteran� 4–Asian � 5–American Indian or Alaska Native � Surviving Spouse of a Veteran� 6–Native Hawaiian or Other Pacific Islander An option for disabled veterans is provided on Page 3.� 8–Decline to provide information *Former Foster Child Status I am 25 years of age or younger If you selected more than one race (not including and was under the permanent managing conservatorship of the Hispanic or Latino), you will be identified as “Two or Texas Department of Family and Protective Services on the day More Races” for federal and state reporting purposes. preceding my 18th birthday. � Yes � No

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Social Security Account Number: Notice to EmployeesSection 7(b) of the Privacy Act of 1974 (5 U.S.C. 552a) requires that any Federal, State, or local government agency which requestsan individual to disclose his/her Social Security account number shall inform that individual whether that disclosure is mandatory orvoluntary, by what statutory or other authority such number is solicited, and what uses will be made of it.

Accordingly, employees, or applicants for employment, are advised that disclosure of an employee’s Social Security accountnumber (SSAN) is required as a condition for employment within The Texas A&M University System and its members, in view of thepractical administrative difficulties which would be encountered in maintaining adequate employee records without the continueduse of the SSAN.

The SSAN is used to verify the identity of the employee, and as an employee account number (identifier) throughout the period ofemployment in order to record necessary data accurately. As an identifier, the SSAN is used in such employee activities as:determining and recording salary entitlements, payments and deductions, determining, recording, and payment of social securitycontributions by both employees and employing agency; determining, recording, and payment of retirement contributions by bothemployee and employing agency; determining and recording employee annual and sick leave accumulation and use; recordingentitlement and payment for official travel and per diem; determining and recording entitlement and payment for workers’compensation; reporting earnings to the Texas Employment Commission, which serves as the basis for determining any futureunemployment compensation insurance benefits; recording personal data in System group insurance files; determining andrecording service for retirement and other benefits based on length and dates of employment and other service; and such otherrelated requirement which may arise.

Authority for requiring the disclosure of an employee’s SSAN is grounded on section 7(a)(2) of the Privacy Act, which providesthat any Federal, State or local agency maintaining a system of records in existence and operating before January 1, 1975, maycontinue to require disclosure of an individual’s SSAN if such disclosure was required under statute or regulation adopted prior tosuch date to verify the identity of an individual.

The Texas A&M University System and its members require the disclosure of the SSAN on necessary employee forms anddocuments used pursuant to statutes passed by the State of Texas and United States and regulations adopted by agencies of theState of Texas and United States, and by the Board of Regents of The Texas A&M University System.

I have read and understand this material and I certify that the information provided by me is true and correct to the best of myknowledge. This document is executed in good faith.

_____________________________________________ _________________________________________Employee signature Date

The Texas A&M University System is an equal employment opportunity and affirmative action employer.

*Veteran Status� Veteran. The individual has served in the military for not less than

90 consecutive days during a national emergency declared inaccordance with federal law and was honorably discharged frommilitary service, or was discharged for an established service-connected disability, and is competent.

� Armed Forces Service Medal Veteran. The individual is aveteran who, while serving on active duty in the U.S. military,ground, naval or air service, participated in a United States militaryoperation for which an Armed Services Medal was awardedpursuant to Executive Order 12985 (61 Fed. Reg. 1209).

� Other Protected Veteran. The individual has served on activeduty in the U.S. military, ground, naval or air service during a waror in a campaign or expedition for which a campaign badge hasbeen authorized, under the laws administered by the departmentof defense. A list of campaigns and expeditions meeting thiscriteria is on Page 4.

� Recently Separated Veteran. The individual is any veteran duringthe three-year period beginning on the date of such veteran’sdischarge or release from active duty in the U.S. military, ground,naval or air service.

� Orphan of a Veteran. The individual is an orphan of a veterankilled on active duty who had served in the military for not less than90 consecutive days during a national emergency in accordancewith federal law, and is competent.

� Surviving Spouse of a Veteran. The individual is a survivingspouse (who has not remarried) of a veteran killed on active dutywho had served in the military for not less than 90 consecutive daysduring a national emergency in accordance with federal law, and iscompetent.

2

The following definitions are provided for your information and assistance in completing the Employee Personal Data form:EEO Ethnicity/Race� Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican,

South or Central American, or other Spanish culture or origin,regardless of race.

� White. (Not Hispanic or Latino) A person having origins in any ofthe original peoples of Europe, the Middle East, or North Africa.

� Black or African American. (Not Hispanic or Latino) A personhaving origins in any of the Black racial groups of Africa.

� Asian. (Not Hispanic or Latino) A person having origins in any ofthe original peoples of the Far East, Southeast Asia, or the IndianSubcontinent including, for example, Cambodia, China, India, Japan,Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, andVietnam.

� American Indian or Alaska Native. (Not Hispanic or Latino) Aperson having origins in any of the original peoples of North andSouth America (including Central America) and who maintains tribalaffiliation or community attachment.

� Native Hawaiian or Other Pacific Islander. (Not Hispanic orLatino) A person having origins in any of the original peoples ofHawaii, Guam, Samoa, or other Pacific Islands.

HR 181 (11/09)

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Name: __________________________________ __________________________ _______________________________ Last First Middle

UIN or SSN: _______________________ Birthdate: _______________________ Month Day Year

Do you claim to be a Disabled Veteran*? � Yes �� No

A disabled veteran is (1) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but forthe receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans’ Affairsor (2) an individual who was discharged or released from active duty because of a service-connected disability.

*You are not obliged to respond; however, your response is important to meet federal and state reporting requirements. Anyinformation you provide will remain confidential in accordance with applicable federal and state regulations. Your employment willnot be adversely affected by any information you furnish.

Social Security Account Number: Notice to EmployeesSection 7(b) of the Privacy Act of 1974 (5 U.S.C. 552a) requires that any Federal, State, or local government agency which requestsan individual to disclose his/her Social Security account number shall inform that individual whether that disclosure is mandatory orvoluntary, by what statutory or other authority such number is solicited, and what uses will be made of it.

Accordingly, employees, or applicants for employment, are advised that disclosure of an employee’s Social Security accountnumber (SSAN) is required as a condition for employment within The Texas A&M University System and its members, in view of thepractical administrative difficulties which would be encountered in maintaining adequate employee records without the continueduse of the SSAN.

The SSAN is used to verify the identity of the employee, and as an employee account number (identifier) throughout the period ofemployment in order to record necessary data accurately. As an identifier, the SSAN is used in such employee activities as:determining and recording salary entitlements, payments and deductions, determining, recording, and payment of social securitycontributions by both employees and employing agency; determining, recording, and payment of retirement contributions by bothemployee and employing agency; determining and recording employee annual and sick leave accumulation and use; recordingentitlement and payment for official travel and per diem; determining and recording entitlement and payment for workers’compensation; reporting earnings to the Texas Employment Commission, which serves as the basis for determining any futureunemployment compensation insurance benefits; recording personal data in System group insurance files; determining andrecording service for retirement and other benefits based on length and dates of employment and other service; and such otherrelated requirement which may arise.

Authority for requiring the disclosure of an employee’s SSAN is grounded on section 7(a)(2) of the Privacy Act, which provides thatany Federal, State or local agency maintaining a system of records in existence and operating before January 1, 1975, may continueto require disclosure of an individual’s SSAN if such disclosure was required under statute or regulation adopted prior to such dateto verify the identity of an individual.

The Texas A&M University System and its members require the disclosure of the SSAN on necessary employee forms anddocuments used pursuant to statutes passed by the State of Texas and United States and regulations adopted by agencies of theState of Texas and United States, and by the Board of Regents of The Texas A&M University System.

I have read and understand this material and I certify that the information provided by me is true and correct to the best of myknowledge. This document is executed in good faith.

___________________________________________ _________________________________________Employee signature Date

The Texas A&M University SystemDisabled Veteran Status

(continued from the Employee Personal Data form)With few exceptions, you have the right to request, receive, review and correct information about yourself collected using this form. Because this

form contains protected health information about you, it will not be placed in your personnel file.

HR 181-Disability(11/09)

3The Texas A&M University System is an equal employment opportunity and affirmative action employer.

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( )

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The Texas A&M University System Statement of Selective Service Registration Status

With few exceptions, you have the right to request, receive, review and correct information about yourself collected using this form.

HR 203 (2/13)

 Under HB 558, enacted by the 76th Texas State Legislature, if you are currently of the age and gender requiring registration with Selective Service, but knowingly and willfully fail to do so, you are ineligible for employment with an agency in any branch of Texas state government. Any offer of employment is contingent on your compliance with Selective Service law.

 

Exemptions  

Almost all male U.S. citizens, and male aliens living in the U. S., who are 18 through 25 years of age, are required to register with Selective Service. Some non-citizens are required to register and others are not. Non-citizens not required to register include men who are in the U.S. on student or visitor visas, and men who are part of a diplomatic or trade mission and their families. Almost all other male non-citizens are required to register, including illegal aliens, legal permanent residents, and refugees.

 

Non-Registrants  

If you are not registered as required, you are presently not eligible to be hired and should register promptly at a United States Post Office. A Certificate of Mailing may be obtained from the Post Office at such time that you mail your registration and may be used as proof of your application until you receive your Selective Service Registration Card.

Privacy Act Statement  

Because information on your registration status is essential for determining whether you are in compliance with Selective Service law, failure to provide the information requested by this statement will prevent any further consideration of you for employment. This information is subject to verification with the Selective Service System and may be furnished to federal agencies for law enforcement or other authorized use in implementing the law.  False Statement Notification  A false statement may be grounds for not hiring you, or for dismissal, if you have already begun work.  Review  

Should any question arise regarding your registration or eligibility for an exemption, you may request an official "status information" letter from the Selective Service System by calling 1-847-688-6888. As an alternative, you may send a written request to the Selective Service System at P.O. Box 94638, Palatine, IL 60094-4638.

 

Certification of Registration Status  

I certify that I am a male age 18 through 25 and am properly registered with the Selective Service System. I

certify that I am not currently of the age required to register with Selective Service.

I certify that I have been determined by the Selective Service System to be exempt from the registration provisions of Selective Service law.

 I certify that I have not reached my 18th birthday and understand I may be required by law to register at that time.

 

 

I understand that under HB 558, enacted by the 76th Texas Legislature, I must be registered with the Selective Service System according to the requirements of federal law in order to be employed with an agency in any branch of Texas state government. I further certify that the information provided on this form is true, complete and correct to the best of my knowledge. I understand that any false statements may void my application for employment and that the information provided on this form will be used only for evaluation of eligibility for employment. Print Name UIN/SSN Age Registration Number To locate registration number visit: Signature Date https://www.sss.gov/RegVer/wfVerification.aspx

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REQUEST FOR RETIREMENT INFORMATION With few exceptions, you have the right to request, receive, review, and correct information about yourself

collected using this form.

 

Name:  

UIN:  

 

Phone#: E-Mail:  

I have carefully read the information and I have never been offered any of the retirement plans listed below from previous employers.

 

TEACHER RETIREMENT SYSTEM OF TEXAS  

Have you participated in TRS with a past employer?

YES NO

Do you currently work for another employer who withdraws TRS from your income?   YES NO

If yes where?

Are you enrolled in a TRS Health Care Plan as dependent of a TRS retiree?

 

YES NO  

OPTIONAL RETIREMENT PROGRAM Have you elected the Optional Retirement Program in lieu of TRS?

YES NO If yes where?

GENERAL RETIREMENT QUESTIONS  

Are you currently a retiree of any of the following state systems?

Teacher Retirement System of Texas YES NO

Employee Retirement System of Texas YES NO

If you responded yes to either of these questions, please indicate where you retired from below: ________________________________________________________________________

  

Signature: Date:  

Please note that if your employment or retirement status changes you need to contact

the Human Resources office at ext. 2630.  

  

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Form W-4 (2013)Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes.

Exemption from withholding. If you are exempt, complete only lines 1, 2, 3, 4, and 7 and sign the form to validate it. Your exemption for 2013 expires February 17, 2014. See Pub. 505, Tax Withholding and Estimated Tax.

Note. If another person can claim you as a dependent on his or her tax return, you cannot claim exemption from withholding if your income exceeds $1,000 and includes more than $350 of unearned income (for example, interest and dividends).

Basic instructions. If you are not exempt, complete the Personal Allowances Worksheet below. The worksheets on page 2 further adjust your withholding allowances based on itemized deductions, certain credits, adjustments to income, or two-earners/multiple jobs situations.

Complete all worksheets that apply. However, you may claim fewer (or zero) allowances. For regular wages, withholding must be based on allowances you claimed and may not be a flat amount or percentage of wages.

Head of household. Generally, you can claim head of household filing status on your tax return only if you are unmarried and pay more than 50% of the costs of keeping up a home for yourself and your dependent(s) or other qualifying individuals. See Pub. 501, Exemptions, Standard Deduction, and Filing Information, for information.

Tax credits. You can take projected tax credits into account in figuring your allowable number of withholding allowances. Credits for child or dependent care expenses and the child tax credit may be claimed using the Personal Allowances Worksheet below. See Pub. 505 for information on converting your other credits into withholding allowances.

Nonwage income. If you have a large amount of nonwage income, such as interest or dividends, consider making estimated tax payments using Form 1040-ES, Estimated Tax for Individuals. Otherwise, you may owe additional tax. If you have pension or annuity

income, see Pub. 505 to find out if you should adjust your withholding on Form W-4 or W-4P.

Two earners or multiple jobs. If you have a working spouse or more than one job, figure the total number of allowances you are entitled to claim on all jobs using worksheets from only one Form W-4. Your withholding usually will be most accurate when all allowances are claimed on the Form W-4 for the highest paying job and zero allowances are claimed on the others. See Pub. 505 for details.

Nonresident alien. If you are a nonresident alien, see Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens, before completing this form.

Check your withholding. After your Form W-4 takes effect, use Pub. 505 to see how the amount you are having withheld compares to your projected total tax for 2013. See Pub. 505, especially if your earnings exceed $130,000 (Single) or $180,000 (Married).

Future developments. Information about any future developments affecting Form W-4 (such as legislation enacted after we release it) will be posted at www.irs.gov/w4.

Personal Allowances Worksheet (Keep for your records.)A Enter “1” for yourself if no one else can claim you as a dependent . . . . . . . . . . . . . . . . . . A

B Enter “1” if: { • You are single and have only one job; or• You are married, have only one job, and your spouse does not work; or . . .• Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.

} B

C Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse or more than one job. (Entering “-0-” may help you avoid having too little tax withheld.) . . . . . . . . . . . . . . C

D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return . . . . . . . . D

E Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above) . . E

F Enter “1” if you have at least $1,900 of child or dependent care expenses for which you plan to claim a credit . . . F

(Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) G Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.

• If your total income will be less than $65,000 ($95,000 if married), enter “2” for each eligible child; then less “1” if you have three to six eligible children or less “2” if you have seven or more eligible children.

• If your total income will be between $65,000 and $84,000 ($95,000 and $119,000 if married), enter “1” for each eligible child . . . G

H Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) H

For accuracy, complete all worksheets that apply.

{• If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions and Adjustments Worksheet on page 2. • If you are single and have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed $40,000 ($10,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.• If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.

Separate here and give Form W-4 to your employer. Keep the top part for your records.

Form W-4Department of the Treasury Internal Revenue Service

Employee's Withholding Allowance Certificate Whether you are entitled to claim a certain number of allowances or exemption from withholding is

subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.

OMB No. 1545-0074

20131 Your first name and middle initial Last name

Home address (number and street or rural route)

City or town, state, and ZIP code

2 Your social security number

3 Single Married Married, but withhold at higher Single rate.

Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.

4 If your last name differs from that shown on your social security card,

check here. You must call 1-800-772-1213 for a replacement card.

5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5

6 Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . . 6 $

7 I claim exemption from withholding for 2013, and I certify that I meet both of the following conditions for exemption.• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and

• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.If you meet both conditions, write “Exempt” here . . . . . . . . . . . . . . . 7

Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete.

Employee’s signature

(This form is not valid unless you sign it.) Date

8 Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.) 9 Office code (optional) 10 Employer identification number (EIN)

For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 10220Q Form W-4 (2013)

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Form W-4 (2013) Page 2

Deductions and Adjustments Worksheet

Note. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income.1 Enter an estimate of your 2013 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state

and local taxes, medical expenses in excess of 10% (7.5% if either you or your spouse was born before January 2, 1949) of your income, and miscellaneous deductions. For 2013, you may have to reduce your itemized deductions if your income is over $300,000 and you are married filing jointly or are a qualifying widow(er); $275,000 if you are head of household; $250,000 if you are single and not head of household or a qualifying widow(er); or $150,000 if you are married filing separately. See Pub. 505 for details . . . 1 $

2 Enter: { $12,200 if married filing jointly or qualifying widow(er)$8,950 if head of household . . . . . . . . . . .$6,100 if single or married filing separately

} 2 $

3 Subtract line 2 from line 1. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . 3 $4 Enter an estimate of your 2013 adjustments to income and any additional standard deduction (see Pub. 505) 4 $5 Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to

Withholding Allowances for 2013 Form W-4 worksheet in Pub. 505.) . . . . . . . . . . . . 5 $6 Enter an estimate of your 2013 nonwage income (such as dividends or interest) . . . . . . . . 6 $7 Subtract line 6 from line 5. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . 7 $8 Divide the amount on line 7 by $3,900 and enter the result here. Drop any fraction . . . . . . . 8

9 Enter the number from the Personal Allowances Worksheet, line H, page 1 . . . . . . . . . 9

10 Add lines 8 and 9 and enter the total here. If you plan to use the Two-Earners/Multiple Jobs Worksheet,

also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1 10

Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.)Note. Use this worksheet only if the instructions under line H on page 1 direct you here.1 Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 1

2 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if you are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter more than “3” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter “-0-”) and on Form W-4, line 5, page 1. Do not use the rest of this worksheet . . . . . . . . . 3

Note. If line 1 is less than line 2, enter “-0-” on Form W-4, line 5, page 1. Complete lines 4 through 9 below to figure the additional withholding amount necessary to avoid a year-end tax bill.

4 Enter the number from line 2 of this worksheet . . . . . . . . . . 4

5 Enter the number from line 1 of this worksheet . . . . . . . . . . 5

6 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . 6

7 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . 7 $8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed . . 8 $9 Divide line 8 by the number of pay periods remaining in 2013. For example, divide by 25 if you are paid every two

weeks and you complete this form on a date in January when there are 25 pay periods remaining in 2013. Enter the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld from each paycheck 9 $

Table 1Married Filing Jointly

If wages from LOWEST paying job are—

Enter on line 2 above

$0 - $5,000 0 5,001 - 13,000 1

13,001 - 24,000 224,001 - 26,000 326,001 - 30,000 430,001 - 42,000 542,001 - 48,000 648,001 - 55,000 755,001 - 65,000 865,001 - 75,000 975,001 - 85,000 1085,001 - 97,000 1197,001 - 110,000 12

110,001 - 120,000 13120,001 - 135,000 14135,001 and over 15

All Others

If wages from LOWEST paying job are—

Enter on line 2 above

$0 - $8,000 08,001 - 16,000 1

16,001 - 25,000 225,001 - 30,000 330,001 - 40,000 440,001 - 50,000 550,001 - 70,000 670,001 - 80,000 780,001 - 95,000 895,001 - 120,000 9

120,001 and over 10

Table 2Married Filing Jointly

If wages from HIGHEST paying job are—

Enter on line 7 above

$0 - $72,000 $59072,001 - 130,000 980

130,001 - 200,000 1,090200,001 - 345,000 1,290345,001 - 385,000 1,370385,001 and over 1,540

All Others

If wages from HIGHEST paying job are—

Enter on line 7 above

$0 - $37,000 $59037,001 - 80,000 98080,001 - 175,000 1,090

175,001 - 385,000 1,290385,001 and over 1,540

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this

form to carry out the Internal Revenue laws of the United States. Internal Revenue Code

sections 3402(f)(2) and 6109 and their regulations require you to provide this information; your employer uses it to determine your federal income tax withholding. Failure to provide a properly completed form will result in your being treated as a single person who claims no withholding allowances; providing fraudulent information may subject you to penalties. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation; to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their tax laws; and to the Department of Health and Human Services for use in the National Directory of New Hires. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by Code section 6103.

The average time and expenses required to complete and file this form will vary depending on individual circumstances. For estimated averages, see the instructions for your income tax return.

If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return.

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Notice To Employees of Workers' Compensation Insurance

Notice is hereby given to all persons employed in the service of and on the payroll of the institutions and agencies under the direction and governance of the Board of Regents of The Texas A&M University System that Workers' Compensation Insurance coverage is provided in accordance with Chapter 502 of the Texas Labor Code.

I hereby acknowledge receipt of this notice that Workers' Compensation Insurance has been provided as above stated.

DATE:

EMPLOYEE’S PRINTED NAME:

EMPLOYEE’S SIGNATURE:

UIN:

PART OF SYSTEM: TAMUCC

DEPARTMENT:

Retain in Employee’s Personal File

TAMUS 8

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Employee Acknowledgment Form   

I (Employee Name)

, certify that

 

ALL EMPLOYEES (STUDENT, STAFF AND FACULTY) 1. I understand that it i s my responsibility to read the Texas A&M University Ethics Policy at the following link: http://policies.tamus.edu/07-01.pdf

 

2. I understand that I am required to take the following System required training: Course 3001 Information Security Awareness Course 99001 Ethics Course 99002 Creating a Discrimination – Free Workplace Course 99003 Reporting Fraud, Waste and Abuse Course 99004 Orientation to the A&M System Course 2111669 Required Emergency Alert System Notification

 

System Required Training is taken through Single Sign On. Contact Human Resources to obtain your ID and password to Single Sign On: Log on to Single Sign On and click on TrainTraq. Select a course and then click on “Start Course”.

 

3. I understand I am responsible for reading the Texas A&M University-Corpus Christi Rule 34.02.01C1 Alcohol and drugs. http://academicaffairs.tamucc.edu/Rules_Procedures/PDF/340201C1.pdf

 

4. I acknowledge I have been provided and read the Texas A&M University-Corpus Christi Alcohol & Illicit Drugs Standards of conduct, 2012-2013.

 

5. Both Benefit and Non-Benefit Eligible employees are eligible to participate in a Tax Deferred Annuity or the Texa$aver Deferred Compensation Program. Each of these programs provide ways of building personal saving for retirement. You can find more information at: http://www.tamus.edu/assets/files/benefits/pdf/retirement/TDA-DCPoverview.pdf

 

BENEFIT ELIGIBLE GRADUATE STUDENTS, STAFF AND FACULTY 6. I acknowledge that if I am in benefits eligible position, Human Resources will

provide me information pertaining to available Group Insurance and Retirement Programs. I am aware that it is my responsibility to read all of the material given to me and should I have questions concerning this information, I will contact Human Resources for clarification. If eligible for benefits I understand that I have (60) days from my employment date or date of eligibility in which to enroll in or waive the group insurance program.

 I acknowledge that I am responsible for reading the rule and policies listed above. I understand that if I do not have computer access I can request paper copies from the Human Resources Office.

 

  Signature of Employee Date

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ALCOHOL & ILLICIT DRUGS STANDARDS OF CONDUCT, 2012-2013 TEXAS A&M UNIVERSITY-CORPUS CHRISTI

Texas A&M University-Corpus Christi is committed to a campus wide plan to educate students and employees about alcohol and drug issues, discourage the irresponsible use of alcoholic beverages, and prohibit the unlawful use, possession or distribution of controlled substances. The University will act to ensure compliance with all local, state, and federal laws and A&M University System policies dealing with controlled substances, illicit drugs, and the use of alcohol. The University prohibits the use or possession of alcoholic beverages on campus by any individual under the age of 21. Failure to comply with this rule violates state law and the rules governing student conduct and will subject the individual to disciplinary action. Students of lawful age under Texas Statutes may possess and/or consume alcoholic beverages in the privacy of their rooms or apartments in campus residence facilities. However, occupants and their guests must comply with state and local statutes concerning possession, sale, and consumption of alcoholic beverages. Any use of alcoholic beverages should be in moderation. Therefore, bulk quantities of alcohol (kegs, cases, party balls, etc.) are not allowed on campus or in residence facilities. Loud or disruptive behaviors, interference with the cleanliness of residence facilities, or drinking habits that are harmful to the health or education of an individual or those around him/her are reasons for appropriate disciplinary action by the University. Except for the limited circumstances specified in University Rule 34.02.01.C1, the possession of open containers and the consumption of beer, wine, and/or distilled spirits are prohibited in all public areas of the campus. For the purposes of this rule, residence facilities’ balconies and patios are considered public areas. Although students of lawful age may possess and consume alcoholic beverages in the privacy of their rooms or apartments, all alcoholic beverages transported through public areas on the University grounds and in residence facilities must be unopened and concealed. All members of the University community are expected to abide by state and federal laws pertaining to controlled substances and illicit drugs. Standards of conduct strictly prohibit the unlawful manufacture, distribution, possession or use of controlled substances, illicit drugs or drug paraphernalia on University property, at University-sponsored activities, and/or while on active duty. Individuals may use prescription medications that are medically necessary and prescribed by a licensed medical practitioner. While the University has limited jurisdiction when alcoholic beverages and illegal drugs are consumed off-campus, members of the University community are encouraged to consider these regulations as a guideline for responsible and lawful behavior. Any recognized student organization that plans to include alcohol at an official function off-campus must obtain permission from Student Activities under the University risk management guidelines. Failure to comply with this requirement will be reason for appropriate disciplinary action by the University. To implement an effective drug and alcohol abuse prevention plan, the University will use both formal and informal channels of communication to: 1) disseminate information describing patterns of addiction and the physical, mental, and emotional consequences that result from the abuse of alcohol and controlled/illegal substances, 2) distribute information that describes and encourages the use of counseling and treatment modalities available to both students and employees in the local and regional area, and 3) make available to the campus population referrals to local treatment centers and counseling programs. These referrals will be made within a supportive, confidential, and non-punitive environment under the auspices of the University Health Center, Counseling Center, and/or Human Resources. This brochure is prepared in compliance with the Drug Free Schools & Communities Act of 1989 and is distributed annually to all University students and employees.

LEGAL SANCTIONS Zero Tolerance for Minors with Alcohol Law It is illegal for a minor to drive while having any detectable amount of alcohol in his/her system. The consequences of a first offense include being sanctioned by the state for a Class C misdemeanor, punishable by a fine up to $500, attendance at an alcohol awareness class, 20-40 hours of mandatory community service, and 60 days driver’s license suspension (the minor would not be eligible for an occupational license for the first 30 days). A second offense results in the same sanctions, but increases the driver’s license suspension to 120 days (the minor would not be eligible for an occupational license for the first 90 days) and mandatory 40 to 60 hours of community service. If a third violation occurs, the minor is not eligible for deferred adjudication. The minor’s driver’s license is suspended for 180 days (an occupational license may not be obtained during the entire suspension period). If the minor is 17 years of age or older, the fine

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increases to $500-$2,000, confinement in jail for up to 180 days, or both. Minors who purchase, attempt to purchase, possess, or consume alcoholic beverages, as well as minors who are publicly intoxicated or misrepresenting their age to obtain alcoholic beverages face the following consequences: Class C misdemeanor punishable by a fine up to $500, a mandatory alcohol awareness class, 8-40 hours of community service, and 30-180 days loss or denial of driver’s license. If a minor is 17 years of age or older and the violation is a third offense, it is punishable by a fine of $250-$2,000, confinement in jail for up to 180 days or both, as well as automatic driver’s license suspension or denial. Sale or Giving Alcohol to a Minor The punishment for making alcoholic beverages available to a minor is a Class A misdemeanor, punishable by a fine of up to $2,000, confinement in jail for up to 180 days, or both. Sale to a minor is a Class A misdemeanor, punishable by a fine of up to $4,000, confinement up to a year in jail, or both. Public Intoxication A person commits an offense if he/she appears in a public place while intoxicated to the degree that he/she may endanger him/herself or another. Public intoxication is a Class C misdemeanor, punishable by a fine up to $500. Driving While Intoxicated A person commits an offense if he/she is intoxicated while operating a motor vehicle in a public place. Driving while intoxicated is a Class B misdemeanor, with a minimum term of confinement of 72 hours and/or a fine not to exceed $2,000. If it is shown on the trial of an offense under this section that at the time of the offense the person operating the motor vehicle had an open container of alcohol in the person's immediate possession, the offense is a Class B misdemeanor, with a minimum term of confinement of six days and/or a fine not to exceed $2,000. DWI With a Child Passenger Motorist can be charged with child endangerment for driving while intoxicated if they’re carrying passengers younger than 15 years old. DWI with a child passenger is a felony and punishable with up to $10,000 fine, up to two years in state jail, and loss of driver’s license for 180 days. DWI is a Class A misdemeanor if the blood alcohol level is .15 or higher. Possession/Manufacture/Delivery/Trafficking of a Controlled Substance Penalties for possessing or delivering a controlled substance range according to type of substance, amount possessed or delivered, and number and type of previous violations. On the state level, misdemeanors are punishable by up to $2,000 in fines and up to one year in jail or both. Felonies are punishable for by 5-99 years, or life, in prison and up to $20,000 in fines. On the federal level, a first conviction for possession of a controlled substance can result in imprisonment of up to one year, a fine of $1,000-$100,000 or both. Subsequent convictions can result in longer prison sentences, larger fines, or both. Possession of crack cocaine can result in mandatory federal prison terms of 5-20 years, fines up to $250,000, or both. Any person who distributes, possesses with intent to distribute, or manufactures a controlled substance in or on, or within one thousand feet of, the real property comprising a public or private college, junior college, or university is subject to twice the maximum punishment, at least twice any term of supervised release, and a fine up to twice of that authorized may be imposed. Except to the extent a greater minimum sentence is otherwise provided, a person shall be sentenced under this subsection to a term of imprisonment of not less than one year. The mandatory minimum sentencing provisions of this paragraph shall not apply to offenses involving 5 grams or less of marijuana. An individual convicted of trafficking by a federal court can receive up to life imprisonment and be fined up to $8 million. Possession of Alcohol in Motor Vehicle A person commits an offense if he/she knowingly possesses an open container in a passenger area of a motor vehicle that is located on a public highway, regardless of whether the vehicle is being operated or is stopped or parked. "Open container" means a bottle, can, or other receptacle that contains any amount of alcoholic beverage and that is open, that has been opened, that has a broken seal, or the contents of which are partially removed. This is a Class C misdemeanor, punishable by a fine up to $500.

FINANCIAL AID IMPLICATIONS If you have a drug conviction, it might affect your ability to get federal student aid. Your eligibility might be suspended if the offense occurred while you were receiving federal student aid (grants, loans, or work-study). When you complete the FAFSA, you will be asked whether you had a drug conviction for an offense that occurred while you were receiving federal student aid. If the answer is yes, you will be provided a worksheet to help you determine whether your conviction affects your eligibility for federal student aid. If you are convicted of a drug-related offense after you submit the FAFSA, you might lose eligibility for federal student aid, and you might be liable for returning any financial aid you received during a period of ineligibility.

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UNIVERSITY SANCTIONS Student Code of Conduct Students found responsible for violating the rules and regulations will be subject to sanctions commensurate with the offenses and any aggravating and mitigating circumstances. Disciplinary actions in cases involving alcohol and/or drug-related violations may result in sanctions up to and including suspension or expulsion from the University and referral for prosecution. Any disciplinary action imposed by the University may precede and be in addition to any penalty imposed by an off-campus authority. Students will be advised of available alcohol and drug counseling at the University Counseling Center and/or referred to a community organization. The University Counseling Center and the University Health Center can provide assistance and referral to appropriate community agencies. The University sanctions students found in violation of the Student Code of Conduct alcohol rules to an on-line alcohol education course called “Under the Influence” facilitated by 3rd Millennium Classrooms. “Under the Influence” is an offender pay program consisting of nine lessons, quizzes and a final exam. The three hour course includes the eCHECKUP TO GO brief intervention for alcohol (formerly e-CHUG). 3rd Millennium also facilitates an on-line course for student violators of the rules regarding marijuana. “Marijuana 101” is a six interactive lessons including a pre-test and post-test and includes the eCHECKUP TO GO brief intervention for marijuana (formerly e-TOKE). This course also includes a 30-day Part 2 so that you can measure changes in students’ attitudes and behavior. Any previous disciplinary record may be considered when determining sanctions for a current violation of the Student Code of Conduct. Other sanctions that may be assessed for conduct related to the unlawful use, possession, or distribution of drugs or alcohol may include but not limited to eviction from housing, alcohol and/or drug assessment, community service, and other sanctions as deemed appropriate under the circumstances. Employment If a supervisor reasonably suspects that use of a controlled substance or alcohol has resulted in absenteeism, tardiness, or impairment of work performance or is the cause of workplace accidents, the supervisor shall immediately notify the appropriate department head or other designated administrator. Upon direction from the department head or designated administrator, the supervisor or other designated administrator shall discuss with the employee the suspected alcohol or drug-related problems. The employee should be advised of any available alcohol and drug counseling, rehabilitation, or employee assistance programs, and the terms of any applicable disciplinary sanctions. The employee may be required to participate in an assistance program and be subject to discipline (up to and including termination of employment) if he or she rejects participation in the program. All meetings between the employee and the supervisor or other administrator to address the suspected alcohol or drug-related problem and/or its resolution shall be documented in a memorandum to the record and filed in the employee's personnel file. If discussion and/or participation in any available alcohol or drug counseling, rehabilitation, or employee assistance program fail to resolve the suspected alcohol or drug-related problems or if the employee fails to meet the terms of any applicable disciplinary sanctions, the employee may be subject to disciplinary action up to and including termination. Testing of employees other than those occupying DOD-funded sensitive positions or those required to have a commercial driver’s license may be undertaken only when there is reasonable suspicion that the employee is under the influence of alcohol or illicit drugs while on the job, the employee's job performance has been affected by the use of alcohol or illicit drugs, and such impairment presents a risk to the physical safety of the employee or another person. The decision to test an employee in these circumstances will be made by the appropriate chief executive officer or designee with the advice of the Office of General Counsel. The employee should be informed that a refusal to submit to a test, combined with a reasonable suspicion of usage, may be sufficient basis for termination. As a condition of employment, employees on government grants or contracts must abide by the required notification statement and must report any criminal drug statute conviction for a violation occurring in the workplace or on University business to their employer no later than five days after such conviction. The employer, in turn, must so notify the contracting federal agency within 10 days after receiving notice from an employee or otherwise receiving actual notice of such conviction and within 30 days must impose sanctions on the employee involved. Such sanctions may take the form of personnel actions against such an employee, up to and including termination or requiring the employee to satisfactorily participate in an approved drug abuse assistance or rehabilitation program. Faculty members have the responsibility to supervise student activities on field trips. Faculty members should inform students that actions violating state laws, local regulations, and University rules regarding alcohol and drugs will not be

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permitted on any University field trip. Students who violate these guidelines regarding alcohol and drug use on field trips will be subject to disciplinary action.

HEALTH RISKS Alcohol Alcohol abuse can cause many health-related problems. Approximately 150,000 deaths annually are directly related to alcohol abuse and/or alcoholism. Alcohol abuse can lead to alcoholism, premature death through overdose, and complications involving the brain, heart, liver, and many other body organs. Alcohol abuse is the prime contributor to suicide, homicide, motor vehicle deaths, and other accidental causes of death. Alcohol abuse also causes liver disease, gastritis, and anemia. Alcohol abuse interferes with psychological functions, causes interpersonal difficulties, and is involved in many cases of child abuse. Alcohol abuse also disrupts occupational effectiveness and causes legal and financial problems. Alcohol used in any amount by a pregnant woman can cause birth defects. Drugs The abuse of illicit drugs can result in a wide range of health problems. In general, illicit drug use can result in drug addiction, death by overdose, death from withdrawal, seizure, heart problems, infections (i.e., HIV/AIDS, hepatitis), liver disease, and chronic brain dysfunction. Other problems associated with illicit drug use include psychological dysfunction such as memory loss, thought disorders (i.e., hallucinations, paranoia, psychosis), and psychological dependency. Additional effects include occupational, social, and family problems as well as a reduction in motivation. Drug use by a pregnant woman may cause addiction or health complications in her unborn child.

PREVENTION PROGRAMS

Texas A&M University-Corpus Christi offers a variety of educational workshops and programs relating to drugs and alcohol education. Educational tools such as e-Chug, Alcohol Jeopardy Game, Alcohol Poison Training, alcohol and drug assessment/screenings through the University Counseling Center and an online interactive course are available for students. All incoming students under the 21 years of age must complete an online alcohol education and prevention course. For a complete schedule or to request a program specific to the interests and needs of your organization, call the Office of Student Engagement and Success, 361-825-2612 or the University Counseling Center at 361-825-2703.

CAMPUS RESOURCES A&M-Corpus Christi offers a variety of programs to promote healthy lifestyles and substance-free alternatives. Students can become involved with the planning of drug and alcohol education programs by contacting the Office of Student Engagement and Success at 825-2612. Annual Security Report - This report includes statistics for the previous three years concerning reported crimes that

occurred on campus; in certain off-campus buildings or property owned or controlled by A&M-Corpus Christi; and on public property within, or immediately adjacent to and accessible from, the campus. The report also includes institutional policies concerning campus security, such as policies concerning sexual assault, and other matters. Obtain a copy of this report by contacting the University Police Department 825-4444 or by accessing the following web site: http://police.tamucc.edu.

Employee Assistance Program – The Employee Assistance Program (EAP) is designed to help A&M-Corpus Christi

budgeted benefits eligible employees with personal issues including alcohol and drug problems. The EAP is completely confidential, and services are free. To contact the EAP, call 1-800-492-4357.

I-ADAPT - I-ADAPT (Islander’s Alcohol and Drug Abuse Prevention Team) is committed to promoting healthy choices

among the A&M-Corpus Christi campus community in order to reduce the negative consequences of alcohol and drug use/abuse. For more information, you may visit the following website: http://iadapt.tamucc.edu or call 825-2612.

University Counseling Center - The University Counseling Center offers educational programming, screenings,

individual counseling, and support groups focused on alcohol and other drug use, abuse and addiction. For more information, call 825-2703 or visit http://counseling.tamucc.edu.

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University Health Center - The University Health Center offers general medical care for students and can provide specific information about health risks and treatment options for substance misuse/abuse. For more information, call 825-2601 or visit http://healthcenter.tamucc.edu.

University Police Department - The University Police Department educates the University community about drug and alcohol issues as well as enforces local, state and federal law. For more information, call 825-4444 or visit http://police.tamucc.edu.