"Request for off-Cycle Manual Paycheck" - Ohio

Request for off-Cycle Manual Paycheck is a legal document that was released by the Ohio Department of Administrative Services - a government authority operating within Ohio.

Form Details:

  • Released on April 30, 2015;
  • The latest edition currently provided by the Ohio Department of Administrative Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Ohio Department of Administrative Services.

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Download "Request for off-Cycle Manual Paycheck" - Ohio

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REQUEST FOR OFF-CYCLE MANUAL PAYCHECK
EMPLOYEE DATA:
NAME _____________________________________________________ EMPL ID# _______________________
Full Time ____________
Part Time ______________
Temporary ______________
Agency Name & Number ______________________________ PPE _____________ Payday ______________
REASON FOR REQUEST:
(Cancel paper warrant – attach copy of Stop Payment Documentation)
EXPLAIN: ___________________________________________________________________________________
**********************************************************************************************
Complete Off Cycle page two for what needs to be paid
**********************************************************************************************
Deductions for a whole pay period will come out as normal, except health insurance. Health insurance will be done
through arrears process. Deductions for a partial pay period will not be deducted, except for retirement and
garnishments where applicable. If you need a deduction taken that does not fit in the above statement, please
indicate below.
Deductions that need to be taken: _____________________________________________________________________
SIGNATURE:
Agency Approval ___________________________________ Date __________________________ Time ______________________
Telephone ______________________________________ Ext _________________ Fax # __________________________________
Date: ______________________
Prepared by: ________________ Gross: __________________ Net: _____________________ Check # ___________________ Stock # _______________________
I ACKNOWLEDGE RECEIPT OF A CHECK WITH THE ABOVE NUMBER, DATE AND PAYEE
SIGN HERE ____________________________________________________ DATE _____________________________________________
FAX APPROVED FORM TO: DAS HRD PAYROLL SERVICES @ 614.466.1565
NOTE: Form will only be processed if it is approved by an authorized agency central office employee
Revised 4/30/15
REQUEST FOR OFF-CYCLE MANUAL PAYCHECK
EMPLOYEE DATA:
NAME _____________________________________________________ EMPL ID# _______________________
Full Time ____________
Part Time ______________
Temporary ______________
Agency Name & Number ______________________________ PPE _____________ Payday ______________
REASON FOR REQUEST:
(Cancel paper warrant – attach copy of Stop Payment Documentation)
EXPLAIN: ___________________________________________________________________________________
**********************************************************************************************
Complete Off Cycle page two for what needs to be paid
**********************************************************************************************
Deductions for a whole pay period will come out as normal, except health insurance. Health insurance will be done
through arrears process. Deductions for a partial pay period will not be deducted, except for retirement and
garnishments where applicable. If you need a deduction taken that does not fit in the above statement, please
indicate below.
Deductions that need to be taken: _____________________________________________________________________
SIGNATURE:
Agency Approval ___________________________________ Date __________________________ Time ______________________
Telephone ______________________________________ Ext _________________ Fax # __________________________________
Date: ______________________
Prepared by: ________________ Gross: __________________ Net: _____________________ Check # ___________________ Stock # _______________________
I ACKNOWLEDGE RECEIPT OF A CHECK WITH THE ABOVE NUMBER, DATE AND PAYEE
SIGN HERE ____________________________________________________ DATE _____________________________________________
FAX APPROVED FORM TO: DAS HRD PAYROLL SERVICES @ 614.466.1565
NOTE: Form will only be processed if it is approved by an authorized agency central office employee
Revised 4/30/15
PAGE TWO FOR Request for Off Cycle Manual Request
Key EC = Earnings Code D/H=Dollars/Hours
Name_____________________________________________________ EMPLID ________________ AGENCY ____________________
If manual for Additional pay or $ earnings - E C ________________ D/H___________
If re-write - EC _________ D/H_________ EC ________ D/H ________ EC ________ D/H ________
EC ________ D/H ________ EC ________ D/H ________ EC ________ D/H ________
S
M
T
W
TH
F
S
S
M
T
W
TH
F
S
S
M
T
W
TH
F
S
EACH SET OF BLOCKS REPRESENTS A PAY PERIOD TIME FRAME. IF THE REQUEST IS FOR MORE THAN ONE PAY
PERIOD, PLEASE ENSURE YOU FILL IN EACH PAY PERIOD SEPARATELY.
FILL IN THE DATES WITH THE CORRECT CORRESPONDING DAY IN THE PAY PERIOD FOR THE MANUAL
REQUESTED.
REMEMBER TO USE THE APPROPRIATE TRC CODE.
PAYDAY WEEKS-PLEASE ENTER TIME IN OAKS TIMESHEET.
PAY PROCESSING WEEKS-DO NOT ENTER THE TIME IN THE OAKS TIMESHEET (THIS WILL DELAY THE
PROCESSING OF THE MANUAL)
REMEMBER TO ENTER A COMMENT IN THE BUBBLE ON THE OAKS TIMESHEET-(DAS/HRD PAYROLL WILL ENTER
COMMENT AND TIME FOR REQUESTS ON PAY PROCESSING WEEK)
FOR APPROVING AGENCIES, DAS/HRD PAYROLL WILL APPROVE THE PAYABLE TIME WITH THE AUTHOR
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