Unscheduled Payroll/Batch Request Form
Email:
Enter the same email address which you signed in with
Applicable Company Codes:
For multiple companies, enter all company codes separated by a comma. IE. 9999, 9999A, 9999B
Request Type
Select One
I would like to process a one time unscheduled payroll cycle
I would like to process a year-end adjustment payroll
I would like to process prior quarter 3rd Party Sick Pay
I would like to process a prior quarter retro payroll
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
I forgot to pay some employees
Bonus/Commission Payroll
Other
Please Specify the Reason:
Pay Date to use:
Period Begining to use:
Period Ending to use:
Period Beginning:
Period Ending:
Do you need a corresponding time & attendance process to be added along with this unscheduled payroll?
No. I do not use Empeon Time & Attendance or an Attendance process is not needed.
Yes
Special check overrides.:
please checkmark the applicable items. Unless otherwise noted, auto pays will be blocked by default
No special overrides
Block Benefit Accruals from calculating
Block fringe earnings
Block all deductions
Block specific deductions
Block direct deposit
Special tax frequency
Please list the deduction codes to block:
Please specify the tax frequency:
Do you need a special time file import setup for this payroll:
No. I will not be importing, or I will be using my regular import service
Yes
Please attach to this requests a sample of the import file
Click
here
for the time file specs and sample
Special delivery instructions:
If left blank, the payroll package will be shipped using your company’s default shipping arrangements
Unscheduled Batch
Reason for the unscheduled batch:
Bonus/Commission Payroll
Other
Please specify what the batch will be used for:
To what pay date should the batch be added to?
Period beginning to use for the batch:
Period ending to use for the batch:
Do you need a special time file import setup for this payroll?
No. I will not be importing, or I will be using my regular import service
Yes
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)
Agree
Comments:
File
uploader
UPLOAD FILE
I agree to the $50 off cycle payroll processing fee (in addition to my regular processing fees)
Agree
3rd Party Sick Pay
I agree to the $50 3rd Party Sick Pay processing fee
Agree
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
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
Agreed
submit
submit