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Employee Signature Date Approved By Supervisor s Signature IMPORTANT Per UC Davis Policy and Procedure Manual Section 380-57 An employee may receive no more than one payroll advance during a calendar year. UC Davis Health System Payroll Services Department 4900 Broadway Suite 2300 Sacramento CA 95820 Main Phone 916 734-9150 FAX 916 734-9167 EMERGENCY PAYROLL ADVANCE REQUEST TO UCDHS Payroll Representative EMPLOYEE S NAME EMPLOYEE ID Please prepar.

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