Standard Contract Addendum For Completion by Contractor Name: Have you ever held another position at Fitchburg State or another state agency in the Yes No Commonwealth of Massachusetts? If yes, what type of tax document did you receive at the end of the year? W-2 1099 For Completion by Supervisor Department: Fiscal Year: Contractor Title: Contract Start Date: Contract End Date: Per: Rate of Pay: Hour Week Stipend Other_________ Scheduled Hours Per Week: Max Hours Per Week: Number of Teaching Credits: Supervisor Name: (faculty only) Job Description: (Please be as detailed as possible) Supervisor Signature: __________________________________________ Date: _____________________
Standard Contract Addendum For Completion by Contractor Name: Have you ever held another position at Fitchburg State or another state agency in the Commonwealth of Massachusetts? Yes No If yes, what type of tax document did you receive at the end of the year? W-2 1099 For Completion by Supervisor Department: Fiscal Year: Contractor Title: Contract Start Date: Contract End Date: Rate of Pay: Per: Hour Week Stipend Other_________ Scheduled Hours Per Week: Max Hours Per Week: Number of Teaching Credits: (faculty only) Supervisor Name: Job Description: (Please be as detailed as possible) Supervisor Signature: __________________________________________ Date: _____________________
Standard_Contract_with_Addendum_4-14_V3.docx