SHARP EMPLOYEE DATA SHEET


PART A - PERSONAL, JOB & EMPLOYMENT DATA

REQUESTOR INFORMATION

GENERAL INFORMATION

ACTION

PERSONAL INFORMATION - BIOGRAPHICAL DETAILS

Prefix
Gender
Social Security Number - DO NOT submit the SS# through e-mail.  Please contact your HR Consultant if the SS# is required for a data change.

PERSONAL INFORMATION - CONTACT INFORMATION

Phone Numbers
Email Addresses

PERSONAL INFORMATION - REGIONAL

Eligible to work in US?

JOB DATA - WORK LOCATION

JOB DATA - PAYROLL

JOB DATA - SALARY PLAN

JOB DATA - COMPENSATION

JOB DATA - KANSAS INFORMATION

Employment Status:

BENEFIT PROGRAM PARTICIPATION

KANSAS EMPLOYMENT

Length of Service Adjustments

TIME REPORTER DATA

Time Reporter Status
(Interface Agencies Only)

EMPLOYEE REVIEW

* Please FAX a copy of the front page of the review.
ACTION

LEAVE ACCRUALS

*This section is to be used only when there is a change in the CTLA (i.e. adjustment completed)
SICK
VACATION
DISCRETIONARY DAY
COMP TIME
HOLIDAY COMP TIME
MILITARY

Part B - Earnings and Deduction Data

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 (Employer 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


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.