SHARP EMPLOYEE DATA SHEET

Part B - Earnings and Deduction Data

REQUESTOR INFORMATION

PART B - EARNINGS AND DEDUCTION DATA

FEDERAL TAX DATA

Action

Special Tax Status

Tax Marital Status

STATE TAX DATA

Action

Check One
Special Tax Status

SWT Marital Tax Status

Exempt from SUT?

LOCAL TAX DATA

Resident?

GENERAL DEDUCTIONS

United Way:  (Deduction Calc. Routine=Flat Amount)
Action

ORGANIZATIONAL DUES

Action

AGENCY MAINTENANCE (Deduction Calc. Routine=Flat Amount)

Action

STATE LEAVE PAYMENT ASSESSMENT

Action

WORKERS COMPENSATION INSURANCE (Employee Contribution)

(Note:   Leave blank if exempt)
Action

OTHER GENERAL DEDUCTIONS

Action

RETIREMENT PLANS

KPERS
Plan Type

Participation Election


 Group Term Life/Long Term Disability Insurance
Action

VOLUNTARY TAX SHELTERED ANNUITY

Action

Agency Maintenance: (Deduction Calc. Routine = Flat Amount)
Action

VOLUNTARY TAX SHELTERED ANNUITY

Action


ADDITIONAL PAY

Action

Overrides to Job Data
Applies to Pay Periods:


Charge Additional Pay To
 


Please remember to fill out the EMPLID, DEPTID and Name at the top of this form