Form OSPS.99.07 "ACH Stop / Reversal Request" - Oregon

What Is Form OSPS.99.07?

This is a legal form that was released by the Oregon Department of Administrative Services - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2016;
  • The latest edition provided by the Oregon Department of Administrative Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OSPS.99.07 by clicking the link below or browse more documents and templates provided by the Oregon Department of Administrative Services.

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Download Form OSPS.99.07 "ACH Stop / Reversal Request" - Oregon

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ACH STOP / REVERSAL REQUEST
I want to:
 Stop an ACH deposit before the batch is transmitted to Treasury (10:15 a.m. on the
second day after final payroll cutoff. See OSPS Processing Calendar for dates.)
 Attempt an ACH reversal within five banking days after settlement of the erroneous
entry/transaction. RESTRICTIONS APPLY – see relevant section, below.
About the Employee (one per form):
OREGON STATEWIDE
Agency No.
Employee ID No. (No SSN)
Employee Name
PAYROLL SERVICES
(OSPS)
OR __ __ __ __ __ __ __
(503) 378-3518 fax
E-mail:
About the Deposit:
OSPS.Help@oregon.gov
NET DEPOSITS
OSPS
XDNN
Set
Pay Period
Payday
Amount
Routing &
Account No.
USE
Online Resource Center:
1
Code
No.
Ending
Transit No.
ONLY
http://go.usa.gov/bEJk
555
INSTRUCTIONS TO
555
PAYROLL OFFICES:
555
Complete this form online
1-This is the “Reg Set” field on the employee’s P190 screen
at
http://go.usa.gov/BVNG
1. Verify all required fields
FIXED DEPOSITS
are complete.
Pay Period
XDNN
Amount
Routing &
Account No.
OSPS
2. Ensure your agency
USE
Ending
Code
Transit No.
ONLY
number appears on the
(3 chars)
form.
3. Print form. Sign and
date where indicated.
4. Fax completed form to
OSPS.
5. To request a physical
check, follow manual
check guidelines.
Reason for Request:
6. Set P190 flag for
 To prevent employee overpayment (Time removed:  Yes  N/A)
closed months if
 Wage attachment received after payroll ran
requesting a manual
 Late notice of account closure by employee
check or making
 Other: ___________________________________________________________
changes to the original
file.
Submitted by:
For Agency Use Only
Signature: _____________________________
Date: ______________
 P190 Flag Set
 P370 Replacement Sent
ACH Reversal Additional Information and Restrictions
:
(Does not apply to ACH Stops)
 Only managers of the agency payroll function can authorize an ACH reversal.
OSPS Use Only
ACH reversals are NOT GUARANTEED. OSPS will attempt the reversal but will not modify
Received Date Stamp
the employee’s OSPA record until we receive a provisional credit from Treasury. This could
take up to five business days. If at a later date (up to several weeks later) the employee’s
bank denies the return, OSPS bills the agency for the provisional credit.
ACH reversals are heavily regulated by NACHA and are for emergencies only. Some
examples of appropriate use for this process are: sent to wrong account number, incorrect or
duplicate payment amounts.
Before you request an ACH reversal, complete these actions:
 Exhaust all other methods of recovering funds
 Notify employee you will reverse this transaction (NACHA rule). Retain for your files.
For OSPS Use Only
Revised 2/2016
 Info Verified
 P130/P070 entry
 PACH entry
Form No. OSPS.99.07
PRINT
ACH STOP / REVERSAL REQUEST
I want to:
 Stop an ACH deposit before the batch is transmitted to Treasury (10:15 a.m. on the
second day after final payroll cutoff. See OSPS Processing Calendar for dates.)
 Attempt an ACH reversal within five banking days after settlement of the erroneous
entry/transaction. RESTRICTIONS APPLY – see relevant section, below.
About the Employee (one per form):
OREGON STATEWIDE
Agency No.
Employee ID No. (No SSN)
Employee Name
PAYROLL SERVICES
(OSPS)
OR __ __ __ __ __ __ __
(503) 378-3518 fax
E-mail:
About the Deposit:
OSPS.Help@oregon.gov
NET DEPOSITS
OSPS
XDNN
Set
Pay Period
Payday
Amount
Routing &
Account No.
USE
Online Resource Center:
1
Code
No.
Ending
Transit No.
ONLY
http://go.usa.gov/bEJk
555
INSTRUCTIONS TO
555
PAYROLL OFFICES:
555
Complete this form online
1-This is the “Reg Set” field on the employee’s P190 screen
at
http://go.usa.gov/BVNG
1. Verify all required fields
FIXED DEPOSITS
are complete.
Pay Period
XDNN
Amount
Routing &
Account No.
OSPS
2. Ensure your agency
USE
Ending
Code
Transit No.
ONLY
number appears on the
(3 chars)
form.
3. Print form. Sign and
date where indicated.
4. Fax completed form to
OSPS.
5. To request a physical
check, follow manual
check guidelines.
Reason for Request:
6. Set P190 flag for
 To prevent employee overpayment (Time removed:  Yes  N/A)
closed months if
 Wage attachment received after payroll ran
requesting a manual
 Late notice of account closure by employee
check or making
 Other: ___________________________________________________________
changes to the original
file.
Submitted by:
For Agency Use Only
Signature: _____________________________
Date: ______________
 P190 Flag Set
 P370 Replacement Sent
ACH Reversal Additional Information and Restrictions
:
(Does not apply to ACH Stops)
 Only managers of the agency payroll function can authorize an ACH reversal.
OSPS Use Only
ACH reversals are NOT GUARANTEED. OSPS will attempt the reversal but will not modify
Received Date Stamp
the employee’s OSPA record until we receive a provisional credit from Treasury. This could
take up to five business days. If at a later date (up to several weeks later) the employee’s
bank denies the return, OSPS bills the agency for the provisional credit.
ACH reversals are heavily regulated by NACHA and are for emergencies only. Some
examples of appropriate use for this process are: sent to wrong account number, incorrect or
duplicate payment amounts.
Before you request an ACH reversal, complete these actions:
 Exhaust all other methods of recovering funds
 Notify employee you will reverse this transaction (NACHA rule). Retain for your files.
For OSPS Use Only
Revised 2/2016
 Info Verified
 P130/P070 entry
 PACH entry
Form No. OSPS.99.07