Form Name:
|
Used for:
Requesting adjustments to an employee's normal pay, in the form of:
1.Reduction for overpayment.
2.Additional payment (current pay period).
3.Retroactive adjustment (prior pay periods).
Required Fields:
| Social Security number and name: | Format last, mi, first |
| Pay Cycle: | Enter M1 (Monthly); S1 (Semi-Monthly); W1 (Weekly); or S2 (Student) |
| Pay Per Ending: | End date of the next pay period in which the employee is paid. Please note deadlines for submission. |
| Reduction in Pay (Overpayment) | |
| Earn Type: | Identify earnings code to be reduced - see HRMS Users Guide for proper codes Show all that apply. |
| Hours: | Indicate hours to the second decimal point (i.e. one and one half hour is 1.50). Applies to all payrolls, for monthly employees use 1.00 in this field and show gross amount in hourly rate field. |
| Hourly Rate: | Show dollar rate to third decimal. Applies to all payrolls. See above for monthly employees. |
| Job Class: | Classification code per Personnel Action Form. |
| Account Number: | 6-digit FRS account, 4-digit subcode. |
| Additional Payment | |
| Pay End Date: | Date of current or future (vacation advance) pay period. Normally same as Pay Period Ending field. |
| Earn Type: | Identify earnings code to be affected - see HRMS Users Guide for proper codes. |
| Hours: | See description under "Reduction in Pay". |
| Sep/Vol/Ded: | Leave blank, Payroll will complete. Indicate under "Reasons" if separate check is requested. |
| Rate of Pay: | Hourly rate or gross amount, if monthly. |
| Job Class: | Classification code per Personnel Action. |
| Account Number: | 6-digit FRS account, 4-digit subcode. Adjustment must be split if more than one account is charged. |
| Retroactive Adjustment | |
| Account Number: | 6-digit FRS account, 4-digit subcode. Adjustment must be split if more than one account is charged. |
| Job Class: | Classification code per Personnel Action. |
| Earn Type: | Identify earnings code to be affected - see HRMS Users Guide for proper codes. |
| Gross Amount: | Total amount due from retroactive adjustment. |
| Hours: | Indicate hours to the second decimal point. |
| Pay End Date: | Prior period date(s) to which adjustment applies. |
| Adj.: | Leave blank - system adjusts per earn type. |
| Reasons: | Provide a detailed explanation for the adjustment. |
| Signatures: | Indicate department name and obtain authorized department and University signatures. |
Documents to Attach:
None Required.
Where to Send:
Forward as indicated on the form. Payroll will route to the Office of Research Administration and Wage and Salary, if necessary.
How to Obtain:
Form is multi-part and stocked in University Stores, number 60441. Use Stock Issue Slip form to order.
Special Notes:
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Please complete form in red ink.
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Refer to "User's Guide to the Human Resource Management System" for assistance.