KIBU/AA.11.6…… KIBABII UNIVERSITY COLLEGE P.O. Box 1699-50200 Bungoma Kenya 020-2028660 / of 0708-085934 / 0734-831729 (A Constituent College ofTel: Masinde Muliro University Science and Technology) E-mail: [email protected] Website: www.kibabiiuniversity.ac.ke UNDERGRADUATE PART-TIME PAYMENT CLAIM FORM (to be completed in triplicate) Claimant’s Name ......................................................Year ................Semester: First/Second Designation: (Lecturer, Senior Lecturer, Associate Professor, Professor) (A) Teaching Allowances Teaching @ Kshs.1,200, Kshs.1,500 per contact hour. (Circle the applicable designation and rate ) Period: From: .......................................... To:…………………………………. Dates No. of Hrs Amount (Kshs) a) .......................... .................................... .................................... b) .......................... .................................... .................................... c) .......................... .................................... .................................... d) .......................... .................................... .................................... e) .......................... .................................... .................................... Total Less 30% with holding tax Net (C) Setting and Marking i) Setting @ Kshs.1,000 per paper Course Code & Title .................................... ……………………... No. of Students Amount (Kshs) a) ..................................................................... ......................... ……………… b) ..................................................................... ......................... ……………... c) ..................................................................... ......................... ……………… d) ..................................................................... ......................... ……………… ......................... ……………… Total ii) Marking @ Kshs.20.00 per script Course Code & Titles No. of scripts Amount (Kshs) External part-time claim form PTC 03A Course Code ……………………. Title ...................................................................... a) ..................................................................... ........................ ……………… b) ..................................................................... ........................ ……………… c) ..................................................................... ........................ ……………… d) ..................................................................... ........................ ……………… e) ..................................................................... ........................ ……………… Total …………........ ……………… Amount (Kshs) i) Honorarium (Net) .................................... ii) Setting .................................... iii) Marking .................................... iv) Subsistence v) Meal Allowance .................................... vi) Transportation vii) Others (Please specify) .................................... Grand Total (E) Signed: .......................................................... Date: ...................................... CLAIMANT Signed: .......................................................... Date: ...................................... CHAIRPERSON OF DEPARTMENT Signed: .......................................................... Date: ...................................... DEAN OF FACULTY Signed: .......................................................... Date: ...................................... REGISTRAR (Academic Affairs) Signed: .......................................................... Date: ...................................... FINANCE OFFICER NOTE: The claimant should make sure that the following conditions are met before submitting his/her claim for payment:- The claim form is duly signed by the signatories - Attach copy of appointment letter - Attach copy of teaching time table External part-time claim form PTC 03A (D) Totals