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No error, response/explanation provided.
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Error confirmed as described above, requested remedy approved.
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Error confirmed, except as specified below, requested remedy approved.
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Other action taken, as follows:
Payroll Services Response Date:
Please print or type:
Pay problem: Pay shortage Overpayment
Benefit deduction error Other
Be as specific as possible, include earnings or benefit item in question & correction you believe is needed.
☐ Apply adjustment(s) to next regular payroll
(For shortages, you will see a Retro earnings item for the amount of gross pay shortage on next pay stub.)
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Issue check for additional net pay as soon as feasible
(As above, you will see a Retro for gross pay shortage added on next pay stub, but also a corresponding reduction to
net pay (“DrawRepay”) because the net amount owed was paid separately, prior to the payroll.)
Attach any additional documentation as may be necessary to verify pay issue or substantiate your request.
Scan/e-mail signed, completed forms To: amollen@wrangell.com and Cc: lburgess@wrangell.com. Include
in Subject “Notice of Pay Problem,” name of employee affected, and month in which it occurred. Signed
forms may also be submitted in person at City Hall.
Request for Pay Correction
City and Borough of Wrangell