Company Change Form - NY Sick Time Accrual

Company Change Form - NY Sick Time Accrual
Client Number
Client Name
Company Number *
Company Name *
Contact Name *
Contact Phone Number *
Please enter a valid phone number.
Contact Email
example@example.com
PayData Customer Service Representative *
Date Requested

Month Day Year
Change Effective Date *

Month Day Year
Please note: for proper audit, PayData requires advance notice of 5 business days for company changes.
Does your company currently offer paid time off to employees?
Please review the link below to ensure compliance.

https://www.nysenate.gov/legislation/laws/LAB/196-B
Select the description that accurately describes your company.
Notes or special instructions:
Add new earning code "NY Paid Sick" - Code type: ED to my account.

Yes, Add "NY Paid Sick" code type ED to my account.
Which calculation groups does this need to be added to? (ex.: Pension, disposable earnings, etc.)
Name of Accrual:
**Please Note: it is the employers' responsibility to tell PayData which employees should receive this bank.
For Hourly Employees:

Salaried Employees that need a per pay period accrual will need hours memoed within their check.
Should the accrual be on worked hours only? (ex: exclude holiday, jury duty, etc.)
Which Earn Code(s) to exclude?
Do you have a PayData timeclock?
Add this code to the timeclock?
Add to OT calculation?

Accrual of NY Sick Pay was eligible to start 9/30/2020.

If you have not discussed this with your Client Service Representative, please provide starting balances for each eligible employee from check dates starting 9/30/2020 - current.

Clients will be responsible for ensuring time is not used before 1/1/2021.
Client Signature

Clear
Should be Empty:

For Hourly Employees: