Employee Name (Last, First, Middle)
Balance per Email
Date of Email
Desired
Adjustment
Corrected End
Balance
Annual
Compen
satory
Reaso
n for Requested Adjustment and Comments:
Date Leave
Taken or
Position Suffix
Recorded
Hours
Requested by (typed name) Requested by (signature)
Date Contact Telephone #
Approved by (typed name) Approved by (signature)
Date
Contact Telephone #
*This form is used to correct leave balances after the employee's final salary/wage payment has been processed, in preparation
TERMINAL LEAVE ADJUSTMENT FORM
Reply All to terminated pay e-mail and attach this document
Timesheet Organization Name
Decrease/
From Earnings
Code:
Increase/To
Earnings Code
Employee's Pay Cycle
OKLAHOMA STATE UNIVERSITY PAYROLL SERVICES
Contact Payroll Services with Questions 405-744-6372
Employee ID Number
Timesheet Organization Number
for the terminal leave payout. If the employee's final salary/wage payroll has not yet been processed, use the Monthly Leave
Adjustment Form or the Biweekly Prior Period Hours & Leave Adjustment Form instead.
Terminal Leave Adjustment Form revised 1.4.22 - see PSP15-5002.xls
biweekly
m
Enter the leave balances show
n
o
n on the Terminal Leave Payout email, the date of the email, and the desired adjustment (in hours).
y
m
m
monthly
x
0.00
Terminal Leave Adjustment Form
Header
All Header information is from Banner screen NBAJOBS.
Employee ID Number, Employee Name - Job Detail Tab
Timesheet Organization Number, Timesheet Organization Name, Pay Cycle (Payroll ID) - Payroll Default Tab
Leave Balances, Date of Email, Desired Adjustment, and Corrected end Balance
When an employee's final paycheck is fully calculated and remitted to the state for payment, the
departmental contact will be notified via email of the balances to be paid.
The date of the email and the balance(s) shown in the email should be entered.
The desired adjustment, positive or negative (to increase or decrease the balance to be paid out) should
be entered. The Corrected End Balance will be calculated automatically.
Please review the Corrected Ending Balance and verify that this is the amount to be payout out as terminal
leave, subject to maximum payout limitations.
In the case of a monthly employee who terminates after the 15th of the month, the final leave report
should be submitted prior to the deadline. Any hours taken but not yet recorded can be deducted from
the "Balance per Email".
Reason for requested adjustment and additional information (Required)
Explain in detail why the balance in Banner is not correct, and provide any pertinent dates. For example,
"The employee took annual leave on MM/DD/YY but forgot to enter it on his/her leave report. Therefore,
the annual leave balance needs to be reduced by 8 hours."
Data Area
Position and Suffix - provide the employee's primary position and suffix, which can be found on Banner
screen NBAJOBS.
Date Leave Taken or Recorded - enter the date(s) for which earnings needto be adjusted. See
"Reason for Requested Adjustment" above. Multiple dates or ranges may be entered if necessary.
Hours - enter the number of hours to be increased or decreased.
Earnings Codes to Increase or Decrease - there will be an increase or decrease to a leave code (170 or 300)
and an offsetting increase or decrease to the leave code that was originally paid (most commonly 010
for monthly employees or 020 for biweekly employees).
Earnings Codes
Transfer/Adjust Hours
Same Leave Code as originally paid - 120 if regular earnings are affected too
010 - Regular Monthly
020 - Hourly Pay
150-Holiday Pay
170-Annual Leave
180-Sick Leave
230-Military Leave
240-Administrative Leave
250-Jury Duty
300-Comp Leave Taken
420-Unpaid Leave
Other - Please contact Payroll Services
Terminal Leave Adjustment Form revised 1.4.22 - see PSP15-5002.xls 1 of 1