Unscheduled Payroll/Batch Request Form

Reason for the unscheduled payroll:Please keep in mind that you can always issue unpaid employees a manual check without having to process a separate payroll
Do you need a corresponding time & attendance process to be added along with this unscheduled payroll?
Special check overrides.:please checkmark the applicable items. Unless otherwise noted, auto pays will be blocked by default
Do you need a special time file import setup for this payroll:
Please attach to this requests a sample of the import file
Click here for the time file specs and sample

Unscheduled Batch
Reason for the unscheduled batch:
Do you need a special time file import setup for this payroll?
Please attach to this requests a sample of the import file
Click here for the time file specs and sample
I agree to the $25 setup fee (in addition to my regular processing fees)
Fileuploader
I agree to the $50 off cycle payroll processing fee (in addition to my regular processing fees)

3rd Party Sick Pay

I agree to the $50 3rd Party Sick Pay processing fee
Processing a backdated payroll may result with late tax payment notices/penalties. I understand that Empeon will not handle or take any responsibility for late tax payment notices/penalties that may occur due to a retro payroll process.
I understand that it is the client’s responsibility to verify that all items were set up as requested, and it is the client’s responsibility to test the accuracy of the calculations resulting directly or indirectly from this request.
In no event will Empeon be liable for any direct, indirect, incidental, consequential, punitive, or monetary damages, occurring as a result of this request, whether or not such damages were foreseeable and even if Empeon was advised that such damages were likely or possible.
Client Agreement Confirmation