UNIVERSITY OF PITTSBURGH \ FORM INSTRUCTION GUIDE FORM TITLE: FACULTY/STAFF LABEL REQUEST NUMBER: FORM 0167 PROCEDURE: 10-01-01 ENTER THE FOLLOWING INFORMATION WHERE INDICATED. GENERAL 1. FAIS Account Number to be charged (N-NNNNN-NNN) 2. Date labels are needed 3. Name of Requester 4. Requester's Campus Phone Number 5. Requester's Department 6. Five-digit department code 7. Requester's Campus Address (Room Number and Building) 8. Signature of requester and date 9. Signature of FAIS Account Administrator and date LABEL AND LIST SPECIFICATIONS Check all that apply unless instructed to select only one. 10. Type of Label: Cheshire Able-Stick Mailroom Machine Applied Adhesive Backed - Manually Applied Used primarily for large quantities Recommended for departmental use Not recommended for bulky items For Mailroom use, limited to quantities under 1,000 11. Number of complete label sets needed 12. If requesting accompanying name and address list (verification list), indicate whether listing should be sorted by name, social security number, or PR number. 13. Number of copies of verification list needed 14. Requests that labels be returned directly to the requester must have the authorization of the Data Administrator, otherwise the labels will be forwarded to Mailing Services. Provide an explanation for returning the labels to the requester in the comments section below. 15. Additional comments, if necessary Check all that apply unless instructed to select only one. FACULTY/STAFF SELECTION SPECIFICATIONS 16. Employee Type - For Employee Types other than those listed, enter the Employee Type Code from DED Table 18322. 17. Independent Lists: Administrative Distribution List - Administrative Officers, Deans, Directors, Department Heads: maintained by the Office of the Provost Managerial Distribution List - Managers, Supervisors: Maintained by the Office of Human Resources 18. Employee Status (DED Table 18279) Active Sabbatical Leave Leave of Absence Terminated 19. Employment Status (DED Table 18323) Regular Full-time Regular Part-time Temporary Full-time (Staff Only) Temporary Part-time (Staff Only) 20. Address Type - Select Only One Campus Address - Room Number and Building (Sorted by building) Home Address - Mailing address from the Employee Record (Sorted by Zip code) 21. Campus(es) 22. Special: Non-Union - University of Pittsburgh employees not covered by a union collective bargaining agreement UPMC - University of Pittsburgh Medical Center: includes Pittsburgh Cancer Institute, and School of Medicine (Clinical and Administrative) 23. Other Selection Criteria. To select individual codes, attach a separate list. See the following DED Tables for listing of codes: Union Codes Payroll - DED Table 18735 Responsibility Center Codes - DED Table 18205 Department Codes - DED Table 18321 Job Classification Codes - Table 18324 DEMOGRAPHIC DATA For all employees, Race, Sex, and Birth date may be left blank. Default condition is all. Use these boxes to make individual selections only. 24. Race (DED Table 11020) Black - having origins in any of the Black racial groups of Africa Asian/Pacific Islander - having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area Includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa American Indian/Alaskan Native - having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition Hispanic - having origins in Mexico, Puerto Rico, Cuba, Central or South America or other Spanish Culture or origin, regardless of race White - having origins in any of the original peoples of Europe, North Africa, or the Middle East 25. Sex: Male Female 26. To select employees of a specific age, or within a specified range, enter appropriate birth date(s): Up to and including the date specified After and including the date specified Between and including the range of dates specified. SPECIAL LABEL REQUESTS 27. For special selection criteria not listed above, attach a separate sheet describing the unique specifications.