See form instructions below.
1. Enter Employee Name
2. Enter Employee ID Number
3. Indicate the appropriate type of overpayment:
A. Overpayment PRIOR Pay Date – check this box if the overpayment occurred on a previous pay cycle
B. Overpayment PENDING Pay Date – check this box if the overpayment is scheduled for an upcoming pay cycle
4. Indicate the appropriate reason for the overpayment:
A. Employee Separation – check this box if the employee is separating from the University and the end date was not entered in time.
B. Leave Without Pay – check this box if the leave without pay was not entered in time
C. Other (Explain)
5. Indicate the Check Date and Pay Period(s) when the overpayment occurred.
6. Net Calculation – check this box if you are requesting a net amount for the employee to write a check to the University.
Note: Net calculations will only be calculated if the employee provides written consent to repay the overpayment with a personal check.
7. Attached Payroll Check – check this box if you are returning a Payroll Check.
8. Provide the pay information for the overpayment you are trying to recover:
A. Chartstring – enter the Chart of Accounts the employee should be paid on
B. Title Code – Four digit job code
C. Gross – enter the gross amount of the overpayment to recover
D. Rate – for a salaried employee, enter the monthly rate; for an hourly employee, enter the hourly rate
Note: TRM, CMP& OTS DOS codes should be paid as hourly rate – for salaried employee, convert the monthly rate to hourly rate – (monthly rate divided by 174).
E. Hours/% – for salaried employee, enter a percentage symbol (%); for a hourly employee, enter an H. (EXAMPLE: For a salaried employee use 0.1904% OR for an hourly employee use 32.00 H)
F. Transaction Type – LX or RX (use drop down list)
G. Pay Period End Date – the pay period to be recovered
H. DOS – the description of service associated to this transaction (i.e. regular pay (REG), vacation payout (TRM), comp time payout (CMP), etc.)
I. WSP – enter work-study code, when applicable.
9. Personal Check Attached – check this box if you are attaching the employee personal check for repayment.
10. Enter departmental contact information:
A. Form Prepared By – enter the name of the preparer.
B. Department – enter the name of the department.
C. Contact Phone Number – enter the contact phone number of the preparer.
D. Date Prepared – enter the date this form was prepared.
NOTE: Please use RequestToRecoverOverpayment_2nd page (PDF) for additional transactions. Please indicate page number.