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Bureau of State Payrolls

Payroll Forms

FORM # DESCRIPTION
DFS-A3-1897 Reduction or Exemption from Withholding Form
DFS-A3-1898 Requisition for Payment of Sick Leave Upon Termination for Beneficiary Payments Only
DFS-A3-1899 Beneficiary Payment Request Check-Off Sheet
DFS-A3-1900 Payroll Certification
DFS-A3-1901 Beneficiary Overtime Payroll Requisition
DFS-A3-1902 Payroll by Exception Change Order
DFS-A3-1903 Beneficiary Payroll by Exception Change Order
DFS-A3-1904 Beneficiary Criminal Justice Incentive Program Change Order
DFS-A3-1905 Backpay/Settlement Request Check-Off Sheet
DFS-A3-1906 Retroactive Payment Schedule-Manual Payroll Register
DFS-A3-1907 Dual Employment Calculation of Overtime Hours
DFS-A3-1908 Certification of Interim Earnings/Unemployment Compensation Benefits
DFS-A3-1909 Manual Payroll Register
DFS-A3-1910 Manual Payroll Register Beneficiary
DFS-A3-1911 Refund for Overpayment of Salary
DFS-A3-1912 Beneficiary Affidavit
DFS-A3-1913 Nonrecurring Compensation Requisition for Military Leave Payments
DFS-A3-1915 Nonrecurring Compensation Requisition for Session Subsistence Payments
DFS-A3-1916 Nonrecurring Compensation Requisition for Excess Intra-District Expense
DFS-A3-1917 Nonrecurring Compensation Requisition for Taxable Travel
DFS-A3-1918 Nonrecurring Compensation Requisition for Toll Allowance Payments
DFS-A3-1919 Nonrecurring Compensation Requisition for Quarterly Sales Incentives
DFS-A3-1920 Nonrecurring Compensation Requisition for Quarterly Sales Annual Incentives
DFS-A3-1921 Nonrecurring Compensation Requisition for FICA Wage Disability Benefits
DFS-A3-1922 Nonrecurring Compensation Requisition for Non-FICA Disability Benefits
DFS-A3-1923 Nonrecurring Compensation Requisition for Annuity Health Insurance Subsidy
DFS-A3-1924 Nonrecurring Compensation Requisition for Extra State Compensation/Supplements
DFS-A3-1925 Nonrecurring Compensation Requisition for Retroactive Payments
DFS-A3-1926 Beneficiary Non Recurring Compensation Requisition
DFS-A3-1927 Bureau of State Payrolls Judgment Debtor Information Form
DFS-A3-1928 Bureau of State Payrolls Garnishment Fax Form
DFS-A3-1929 DFS/Accounting and Auditing Accountable Plan Check-Off List
DFS-A3-1930 Authorized Signature Form
DFS-A3-1931 Criminal Justice Incentive Program Class Code/Position Number Table Maintenance Request
DFS-A3-1932 FICA Refund Request
DFS-A3-1933 Employee Record Adjustment On-Line Miscellaneous ADJ
DFS-A3-1934 Requisition for Payment of Sick Leave Upon Termination
DFS-A3-1935 Expense, Retirement & Payroll Deduction Warrant Cancellation Memorandum
DFS-A3-1939 Affidavit
DFS-A3-1940 Nonresident Alien FICA Refund Request
DFS-A3-1941 Foreign National Information Form
PAYROLL2003.MDE
(zipped file, right-click and download)
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