Payroll Overpayment Form

Payroll Overpayment Form

Requester First Name*

Requester Last Name*

Requester's email address*

Employee First Name*

Employee email address*

Overpayment Category*

Select the PRIMARY reason for the overpayment.

Select

Compensation Error*

Select

Hiring Process Error*

Select

Leave of Absence*

Select

Termination Error*

Select

Time Reporting Error*

Select

Multiple Categories?

Check this box if the overpayment crossed more than one of the above categories and please list the additional categories in the Submitter Comments box below.

1 - Gross Overpayment Amount

1 - Position number

Enter this value as "P12345678"

1 - Org*

Please use the 4 digit numeric org associated with this payment

1 - Earnings Type

Select or enter value

2 - Gross Overpayment Amount

2 - Position number

Enter this value as "P12345678"

2 - Org*

Please use the 4 digit numeric org associated with this payment

2 - Earnings Type

Select or enter value

3 - Gross Overpayment Amount

3 - Position number

Enter this value as "P12345678"

3 - Org*

Please use the 4 digit numeric org associated with this payment

3 - Earnings Type

Select or enter value

4 - Gross Overpayment Amount

4 - Position number

Enter this value as "P12345678"

4 - Org*

Please use the 4 digit numeric org associated with this payment

4 - Earnings Type

Select or enter value

5 - Gross Overpayment Amount

5 - Position number

Enter this value as "P12345678"

5 - Org*

Please use the 4 digit numeric org associated with this payment

5 - Earnings Type

Select or enter value

6 - Gross Overpayment Amount

6 - Position number

Enter this value as "P12345678"

6 - Org*

Please use the 4 digit numeric org associated with this payment

6 - Earnings Type

Select or enter value

7 - Gross Overpayment Amount

7 - Position number

Enter this value as "P12345678"

7 - Org*

Please use the 4 digit numeric org associated with this payment

7 - Earnings Type

Select or enter value

8 - Gross Overpayment Amount

8 - Position number

Enter this value as "P12345678"

8 - Org*

Please use the 4 digit numeric org associated with this payment

8 - Earnings Type

Select or enter value

9 - Gross Overpayment Amount

9 - Position number

Enter this value as "P12345678"

9 - Org*

Please use the 4 digit numeric org associated with this payment

9 - Earnings Type

Select or enter value

10 - Gross Overpayment Amount

10 - Position number

Enter this value as "P12345678"

10 - Org*

Please use the 4 digit numeric org associated with this payment

10 - Earnings Type

Select or enter value

Submitter Comments/Additional Information

Send me a copy of my responses