Netchex Custom Report Request

Netchex Custom Report Request

Please complete the below form to request a custom report from Netchex. If multiple custom reports are needed, please complete a request form for each report. If multiple company codes, please only submit 1 request form.
Custom Report Request
What is your name?*

First NameLast Name
Are you:*

An Active Netchex ClientA Prospective ClientCurrently in ImplementationA Netchex EmployeeA Carrier
Who should we send the quote for this report?*

MyselfOther
What is their name?*
What is their email?
example@example.com
What is your expected first check date with Netchex? If you are unsure, you may leave this blank.

MonthDayYear
Date
Is this request for an existing report within you hierarchy?*

YesNoI'm not sure
Company Name:*
Please enter your company name as it is displayed in Netchex.
Netchex Company Code(s):*
Please enter the three-letter Netchex company code/s that will utilize this report. Please list ALL Netchex company codes that will need this report.
Custom Report Contacts
Client's Name:*

First NameLast Name
Client's Email Address:*
example@example.com
Client's Phone Number:*
Please enter a valid phone number.
Netchex Representative's Name:*

First NameLast Name
Third Party Contacts
Will there be a third party contact that the Netchex team will need to coordinate with on this report? If no, you may skip the remaining questions in this section.*

YesNoI'm not sure
Third Party Contact's Company Name:
Third Party Contact's Name:

First NameLast Name
Third Party Contact's Email Address:
example@example.com
Third Party Contact's Phone Number:
Please enter a valid phone number.
Report Details
What type of custom report is this?*

401k or other retirement planGeneral LedgerOther
What is the desired output file type for this report?*

CSVTXTXLSXXLSOther
What carrier is this report being delivered to?*
Ex. What is the name of the accounting software, 401k carrier name, etc.
Report Delivery
Which method would you like to use for delivery of the requested report?*

I want to download this file from the Netchex websiteI want Netchex to automatically send this file to specified recipients on a scheduleI want Netchex to automatically send this file to my 3rd Party on a schedule
When generating this report in Netchex, which option would you like available to you?*

Paycheck Date - a calendar option will be available for you to pick a single check date you'd like the report generated fromDate Range - Start Date and End Date fields will be available for you to enter a date range that you'd like the report generated from. The report will include all paycheck dates in the given date rangePayroll Number - a text box will be available for the entry of a single payroll number and the report will contain the appropriate data from only the selected payroll numberOther
If you'd like Netchex to email this report on a schedule, please choose the desired transmission frequency.

WeeklyBi-WeeklyEvery Paycheck Date1st of the MonthEnd of the MonthOther
If you'd like Netchex to email this report on a schedule, please enter the names and email addresses of the desired recipients below.
Additional Information
Please provide any additional details below.
Sample Files

Please use the links below to attach the requested sample files for this report.
Specification Sheet Upload*

Required Upload. Please attach a specification sheet. The specification sheet is typically an Excel document. In this spec sheet, you tell us what fields you want to generate on the report, field names, column headers, the number of columns, etc.
Cancelof
Sample Sheet Upload*

Required Upload. Please attach a sample sheet that will show us exactly how you want the final report to appear. This file must differ from the uploaded specification sheet or a delay in fulfilling your request might occur.
Cancelof
Custom Development Details
If you ("Client") request any solution or feature that requires special or customized software or other development ("Custom Development"), Client must pay Netchex for this Custom Development according to the rates quoted to and agreed upon by Client.

Once this request is submitted, a member of our Software Development team will evaluate the request and contact Client with a quote and expected timeframe of completion. This expected timeframe of completion is based on the estimated number of hours to complete the Custom Development.

If Client agrees to proceed with the request and quote, Netchex will develop the deliverable, and charge Client upon delivery.

Netchex reserves the right to decline any request for Custom Development.
Signature*

Clear
Should be Empty:

Netchex Custom Report Request

Custom Report Request

Custom Report Contacts

Third Party Contacts

Report Details

Report Delivery

Additional Information

Sample Files

Custom Development Details