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.