Form P-4 "Employee Information and Voluntary Recurring Deductions" - South Carolina

What Is Form P-4?

This is a legal form that was released by the South Carolina Comptroller General - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2017;
  • The latest edition provided by the South Carolina Comptroller General;
  • 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 printable version of Form P-4 by clicking the link below or browse more documents and templates provided by the South Carolina Comptroller General.

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Download Form P-4 "Employee Information and Voluntary Recurring Deductions" - South Carolina

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Comptroller General’s Office
Form P-4 (Rev. 2/17)
Employee Information and
Voluntary Recurring Deductions
Employee Information
New Request ________
Change Request ___________
Personal Information (Completed by Employee)
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
ZIP Code
Home Phone:
Alternate Phone:
Email
Job Information (Completed by Employer)
Title:
Personnel No:
Agency Name
Supervisor:
and No:
Work Location:
Email:
Work Phone:
Cell Phone:
Emergency Contact Information (Completed by Employee)
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
ZIP Code
Primary Phone:
Alternate Phone:
Relationship:
Comptroller General’s Office
Form P-4 (Rev. 2/17)
Employee Information and
Voluntary Recurring Deductions
Employee Information
New Request ________
Change Request ___________
Personal Information (Completed by Employee)
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
ZIP Code
Home Phone:
Alternate Phone:
Email
Job Information (Completed by Employer)
Title:
Personnel No:
Agency Name
Supervisor:
and No:
Work Location:
Email:
Work Phone:
Cell Phone:
Emergency Contact Information (Completed by Employee)
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
ZIP Code
Primary Phone:
Alternate Phone:
Relationship:
Voluntary Recurring Deductions
Note: This form is to only be used for Voluntary Deductions offered by non-state third parties who have been assigned
a wage type code by the Office of the Comptroller General. Please contact your Benefits Administrator for any
deductions administered through PEBA, Great West, or FBMC. Please also note that you (Employee) may also make
the changes below within MySCEmployee.
Recurring Voluntary Deductions
Semi-Monthly
Deduction
Wage Type
Deduction Name
Amount
I hereby authorize my employer to deduct from my earnings the amounts indicated above to enable me to participate
in the above payroll deduction plans. I reserve the right to revoke the authorization at any time by giving written notice
to my employer or by making appropriate changes in MySCEmployee.
_________________________________
___________________________
Authorized Agency Signature
Date
_________________________________
___________________________
Employee’s Signature
Title
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