Washington ABLE Payroll Deduction Form
Payroll Deduction FormImportant information about this form: Fill out this form to set up payroll deduction contributions to yourWashington State ABLE account, or to change existing payrolldeduction contributions. To stop payroll deduction contributions,please contact your employer. Review the Employee Checklist (included with this form), and PlanDisclosure. If you are an Authorized Legal Representative and wish to set uppayroll deductions to multiple ABLE accounts, please submit adifferent form for each Washington State ABLE account you want tomake payroll deductions contributions to. Your Washington State ABLE account must be open before yousubmit this form to your Employer and the Plan to start payrolldeductions. Once completed you’ll need to give a copy of this form to yourEmployer and mail the original to the Plan at the address indicated.It may take up to 10 business days from the receipt of this formbefore a payroll deduction can be accepted. Please keep anadditional copy of this form for your records. Make sure you use black ink to type or print clearly in capital letters.1Need help?Give us a call Monday – Fridayfrom 9am – 5pm PT at1-844-600-2253 orfrom 6am – 5pm PT at1-844-888-2253 (TTY)Mail the form to:Washington State ABLESavings PlanP.O. Box 9892Providence, RI 02940-8092Overnight Mail:Washington State ABLESavings Plan4400 Computer DriveWestborough, MA 01581Washington State ABLE account informationName of Beneficiary on the ABLE Account (First and last)--Beneficary’s Social Security or Taxpayer Identification NumberWashington State ABLE account numberv1.4 12/11/20201
Payroll Deduction Form2Payroll deduction instructions(Select one)Set up payroll deductionChanging existing payroll deduction instructions(This will replace any previous payroll deduction instructions for this account)3Employee informationThe employee must be the Washington State ABLE Account Beneficiary or Authorized LegalRepresentative listed on the account.Employee ID Number (For Employer use only)Name of Employee (First and last)Name of EmployerEmployer addressStreet address 1Street address 2CityStateZIP CodeEmployer contact name--Employer telephone numberExt.v1.4 12/11/20202
Payroll Deduction Form4Contribution informationYour employer will deduct the amount indicated below and send to the Plan on your behalf. There is a 10 minimum contribution. ,.Amount (per pay period)//Effective date (This is the date the employee wants the employer to begin his/her payroll deductions)5Contribution typeWhich type of contribution are you making? (Please select one)Standard contribution 15,000 yearly standard contribution limit.ABLE to Work contributionIf the Beneficiary is earning wages, they may contribute an amount equal to their grossincome (see Program Disclosure Booklet for current limits) in addition to the yearly standardcontribution limit. This contribution type is only available if the employee listed in Step 3 isthe Beneficiary.v1.4 12/11/20203
Payroll Deduction Form6Sign the formBy signing below, I authorize my employer to process periodic deductions from my paycheck forcontribution into this Washington State ABLE Savings Plan Account(s). I acknowledge and agree that my remedy for any errors made in connection with thesetransactions is limited to simple reimbursement of the amount of the error. I authorize the Plan and its agents to make adjustments to my account to correct such error. I understand that this Washington State ABLE account may not be credited with my payrolldeduction until the funds are received from my employer and that the date on my payroll stub maynot be the same date the deposit is credited to this account. This authorization will remain in effect until cancelled by me or by the Plan, or upon termination ofmy employment with my employer.If you’re making an ABLE to Work contribution:By signing below, if I’m making an ABLE to Work contribution, I certify that: The Beneficiary is earning wages. This recurring payroll contribution is being initiated with the understanding that the total ABLE toWork contributions for this year are anticipated to be no more than the amount the beneficiary hasearned in gross income for the current year or the current limit (see Program Disclosure Booklet forcurrent limits), whichever is less. The Beneficiary (or the Beneficiary’s employer) has not contributed to a retirement plan, includingdefined contribution plan e.g. 401(k), annuity plan (403(b)), or deferred compensation plan (457(b))Signature of Beneficiary or Authorized Legal RepresentativeDate (mm/dd/yyyy)v1.4 12/11/20204
Payroll Deduction FormEmployee ChecklistPlease read this checklist carefully before completing this form.9Be sure to include your employee ID number on this form to help your employer identify your payrollrecord.9Your payroll deduction form will be rejected in its entirety if:1.you do not provide an account number, or2. the contribution amount is less than 10.9Give a copy of this form to your Employer.9Mail this original form to the Plan at the address indicated. It may take up to 10 days from the receipt ofthis form before a payroll deduction contribution can be accepted.9You must contact your employer to stop payroll deductions.9If you have questions, please contact Washington State ABLE customer service.v1.4 12/11/20205
Payroll Deduction FormEmployer ChecklistThe following information has been developed to help you establish automatic payroll deduction for anyemployee. Please read it carefully before sending funds to the Plan on behalf of any employee via ACH(Automated Clearing House) funds.9The employee must provide his/her ABLE account number on this form in order to set up payrolldeduction.9Code the account type (i.e., deposit) as “Checking” and transmit the funds to Bank of New York Mellon(ABA Number 011001234).9Enter the account number as 740705.9If your Payroll System allows, please enter the Individual Name Field with the employee’s ABLE accountnumber Last Name. Example: Employee ABLE account number 1234567890, Last name Jones 1234567890 Jones. If your payroll system generates the Account Name field automatically and does not allow for manualupdate then we will accept the system generated full name.9It may take up to 10 days from the receipt of this form by the Plan before a payroll deduction can beaccepted.9If you have questions, please contact Washington State ABLE customer service.v1.4 12/11/20206
Payroll orm Please read this checklist carefully before completing this form. 9 Be sure to include your employee ID number on this form to help your employer identify your payroll record. 9 Your payroll deduction form will be rejected in its entirety if: 1. you do not provide an accoun
PAYROLL JOB AID 06.19.13 NC OSC HR/Payroll Training Page 1 of 23 IRS Form 2159 Updated – 06.19.13 COMPLETING IRS FORM 2159 – PAYROLL DEDUCTION AGREEMENT FOR STATE OF NC EMPLOYEES /EMPLOYERS. General Information . PROCESS TITLE: Procedure for Completing IRS Form 2159 – Payroll Deduction Agreement
Payroll/HR End of Year 1 - 3 Payroll EOY No Max - Select this option if the deduction or earning never has a max amount. Recalc Max - Select this option if the deduction or earning will have a total max amount that exists for a lifetime. The EOY routine will reduce an employee’s max amount for th e deduction or earning each year by the YTD to tals for the previous year.
payroll provider will maintain an electronic record of employee deduction election through the self-service system and will maintain court-ordered offset and tax levy documents. VA will properly document all payroll deductions made from an employee's pay. Refer to Appendix B, Deduction Forms, for relevant deduction election forms.
Payroll flows are used for many of your payroll tasks. If you load data, calculate payroll and payments, run reports, or calculate and distribute cost results, you submit payroll flows. Monitor and manage each task and overall payroll flow in Payroll. Verify Your Readiness A good payroll run depends on many accurate and completed tasks.
Payroll/DM Lockout . 14 Payroll Confirmed. Payroll/DM Lockout . 15 Departments review Payroll Register Dashboard . Resume normal . 16 17 PAYDAY . 18 19 20 Martin Luther King. Jr. Day - Holiday . 21 22 23 PAR/DMX Deadline at 9am . PTR Deadline. 24 Payroll/DM Lockout . 25 Payroll/DM Lockout 26 Pay Period Ends: 1/13 – 1/26 Payroll/DM Lockout 27 .
master file data to the outside payroll service provider should not be involved in recording the payroll entries in the general ledger, preparing payroll reconciliations or distributing payroll checks. This employee should also not receive the copies of the final payroll reports (e.g., payroll registers) from the outside payroll service.
Glossary Term Definition DTPR - Department of the Treasury of Puerto Rico also referred to as "Hacienda". Net Payroll - Net payroll is equal to gross payroll less tax withholdings and other deductions. Payroll is paid twice per month on the 15th and 30th (or last day of the month, whichever comes sooner). Other payroll - Other payroll expenses relate to employee withholdings, social security .
NORTH & WEST SUTHERLAND LOCAL HEALTH PARTNERSHIP Minutes of the meeting held on Thursday 7th December 2006 at 12:00 Noon in the Rhiconich Hotel, Rhiconich. PRESENT: Dr Andreas Herfurt Lead Clinician Dr Moray Fraser CHP Medical Director Dr Alan Belbin GP Durness Dr Anne Berrie GP Locum Dr Cameron Stark Public Health Consultant Mrs Sheena Craig CHP General Manager Mrs Georgia Haire CHP Assistant .
