Company Changes

Company Change Request Form
For proper audit, Asure requests a minimum of 3 business days for company changes.
Company Number
Company Name
Client Number (if applicable)
Client Name (if applicable)
Payroll Specialist
Contact Name
Contact Email Address
example@example.com
What type of company change are you requesting?
Please explain changes
Date of Request

MonthDayYear
Date
Change Effective Date

MonthDayYear
Date

Add or Change Earning & Deduction Codes
Type of change
Description or name of code that needs changing
Description of Change
Which code would you like to use?
Please assign this code
Code Type
Description or name of code
Special Taxation (Federal, State, or Local) - If applicable
Override Rate/Calculation
Examples: additional shift, premium, percentage based earning
Please explain the override
Is there a company defined annual limit on this code?
What is the limit?
Add to an Earning or Deduction Calculation Group?
Example: Workers Comp, Taxable Wages, Pension Group, Disposable Earnings. If you are unsure, please reach out to your Customer Service Representative.
Are you sure? No workers' comp or pension calculation groups?
Which Earning or Deduction Calculation Group(s) would you like to add this code to?
Add to General Ledger?
General Ledger Number
Add to Input Worksheet? (if applicable)
Add to E-Sheet (if applicable)
Add to time clock and import function?
Add to OT calculation?
Special Time Clock Notes
Do you want to attach an Agency Check?
Please note: If you are adding a NEW Agency Check, please fill out the Agency Check Form as well.
Who is the check payable to?
Do you want to remove an Agency Check?
Who is the check payable to?
Add to Custom or Report Writer Report?
Please specify all custom reports to be reviewed.
Special instructions or additional notes
Do you have another Earning/Deduction to add or change?

Type of change
Description or name of code that needs changing
Description of Change
Which code would you like to use?
Please assign this code
Code Type
Description or name of code
Special Taxation (Federal, State, or Local) - If applicable
Override Rate/Calculation
Examples: additional shift, premium, percentage based earning
Please explain the override
Is there a company defined annual limit on this code?
What is the limit?
Add to an Earning or Deduction Calculation Group?
Example: Workers Comp, Taxable Wages, Pension Group, Disposable Earnings. If you are unsure, please reach out to your Customer Service Representative.
Are you sure? No workers' comp or pension calculation groups?
Which Earning or Deduction Calculation Group(s) would you like to add this code to?
Add to General Ledger?
General Ledger Number
Add to Input Worksheet? (if applicable)
Add to E-Sheet (if applicable)
Add to time clock and import function?
Add to OT calculation?
Special Time Clock Notes
Do you want to attach an Agency Check?
Please note: If you are adding a NEW Agency Check, please fill out the Agency Check Form as well.
Who is the check payable to?
Do you want to remove an Agency Check?
Who is the check payable to?
Add to Custom or Report Writer Report?
Please specify all custom reports to be reviewed.
Special instructions or additional notes
Do you have another Earning/Deduction to add or change?

Type of change
Description or name of code that needs changing
Description of Change
Which code would you like to use?
Please assign this code
Code Type
Description or name of code
Special Taxation (Federal, State, or Local) - If applicable
Override Rate/Calculation
Examples: additional shift, premium, percentage based earning
Please explain the override
Is there a company defined annual limit on this code?
What is the limit?
Add to an Earning or Deduction Calculation Group?
Example: Workers Comp, Taxable Wages, Pension Group, Disposable Earnings. If you are unsure, please reach out to your Customer Service Representative.
Are you sure? No workers' comp or pension calculation groups?
Which Earning or Deduction Calculation Group(s) would you like to add this code to?
Add to General Ledger?
General Ledger Number
Add to Input Worksheet? (if applicable)
Add to E-Sheet (if applicable)
Add to time clock and import function?
Add to OT calculation?
Special Time Clock Notes
Do you want to attach an Agency Check?
Please note: If you are adding a NEW Agency Check, please fill out the Agency Check Form as well.
Who is the check payable to?
Do you want to remove an Agency Check?
Who is the check payable to?
Add to Custom or Report Writer Report?
Please specify all custom reports to be reviewed.
Special instructions or additional notes
Do you have another Earning/Deduction to add or change?

Type of change
Description or name of code that needs changing
Description of Change
Which code would you like to use?
Please assign this code
Code Type
Description or name of code
Special Taxation (Federal, State, or Local) - If applicable
Override Rate/Calculation
Examples: additional shift, premium, percentage based earning
Please explain the override
Is there a company defined annual limit on this code?
What is the limit?
Add to an Earning or Deduction Calculation Group?
Example: Workers Comp, Taxable Wages, Pension Group, Disposable Earnings. If you are unsure, please reach out to your Customer Service Representative.
Are you sure? No workers' comp or pension calculation groups?
Which Earning or Deduction Calculation Group(s) would you like to add this code to?
Add to General Ledger?
General Ledger Number
Add to Input Worksheet? (if applicable)
Add to E-Sheet (if applicable)
Add to time clock and import function?
Add to OT calculation?
Special Time Clock Notes
Do you want to attach an Agency Check?
Please note: If you are adding a NEW Agency Check, please fill out the Agency Check Form as well.
Who is the check payable to?
Do you want to remove an Agency Check?
Who is the check payable to?
Add to Custom or Report Writer Report?
Please specify all custom reports to be reviewed.
Special instructions or additional notes

Agency Check

Use this form to set up a recurring check to be sent to an agency (Ex. Office of Child Support, Morgan Stanley, etc...)
Agency Name
Agency Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Client Bank Account Number (if different than payroll checks)
Add to General Ledger?
GL # (Debit)
GL Offset # (Credit)
How often would you like Asure to send this check?
Where would you like Asure to send the agency check?
Notes or special instructions

Company Change Request Form