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OSPS Forms
We Have a Form for That
Whatever your interaction with OSPS, you're likely to hear the phrase,
"we have a form for that." 
 
The necessity to document formalized requests for OSPS services and OSPA system modifications means we need most communication in writing.  Standardized forms speed along the service process as they ensure all necessary information is captured at one time.
 
In addition to an alphabetical and a numerical sort, we've broken our forms down into several categories.  Please feel free to suggest alternate placement by contacting the OSPS Help Desk.
 
All files below are pdf unless marked otherwise.
OSPS pdf forms take advantage of the JavaScript language in order to add functionality.  Many of these scripts will perform calculations, allow users to submit forms via e-mail, and alert users to missing data that must be provided.  To activate JavaScript in Adobe Reader:

  1. Right click on the open document in your web browser.
  2. Select Page Display Preferences…
  3. At the dialog box on the left side under Categories: select JavaScript.
  4. On the right pane of the Preferences dialog box JavaScript category, place a check in the box Enable Acrobat JavaScript.
Submit by E-mail button.
The Submit by E-mail button will remain read-only until you place a valid
e-mail address in the field provided and tab or mouse click outside that field.
Can't find it? Click here to view DAS's master forms page.

 
Alphabetical Sort
All forms pdf unless indicated otherwise.
Forms sorted by form name.  See also "Numerical" and "Function" for additional sort options.
See the "Numerical" sort area for last updated dates.
 

Form Name
Form Number
ACH Stop / Reversal Request OSPS.99.07 
Authorized OSPA Signatures 75.45.01.FO 
Cancel an OSPS Issued Check OSPS.99.23 
Code Request Form (except for garnishments) OSPS.99.27 
Corrected W-2 Request (When to Use)  (Refund Certification) PDF Calc Form 
Direct Deposit Form (Sign up, Cancel, Suspend) OSPS.99.25 
Early Paycheck Release Form OSPS.99.16 
Electronic Report Access Request - OSPS OSPS.99.30 
Emergency Pay Advance Request 75.45.02.FO 
Emergency Pay Advance Request - Agency Wrapper (doc) 75.45.02.FO.AGY 
Foreign National Residency Determination OSPS.99.01 
Forged Check Affidavit OSPS.99.22 
​Garnishment Code Request Form ​OSPS.99.33
Lost Check Replacement Form OSPS.99.03 
OSPA System Transaction Entry Request OSPS.99.28 
Pay Card Form (Sign up or Cancel) OSPS.99.19 
Payment Notification Form OSPS.99.24 
Payroll Historic Record Access Request OSPS.99.26 
Stop Payment Notification C-27 
Tax Refund Certification OSPS.99.13 
W-2 Reprint / Reissued Statement Request OSPS.99.04 
W-4 Employee's Withholding Allowance Certificate W-4 

 
Function Sort
All forms pdf unless indicated otherwise.
Forms sorted by form name.  See also "Numerical" and "Alphabetical" for additional sort options.
See the "Numerical" sort area for last updated dates.
 

If you want to do this . . .
Use this form . . .
Form Number
Form Name 
Access online electronic reports OSPS.99.30  Electronic Report Access Request - OSPS
Add a pay code to a benefit package OSPS.99.27  Code Request Form
Cancel a check (employee or payroll vendor) OSPS.99.23  Cancel An OSPS Issued Check
Corrected W-2 process Service Page 
Electronic reports access OSPS.99.30  Electronic Report Access Request - OSPS
Garnishment code request OSPS.99.33  Garnishment Code Request Form
Get a new code (work schedule, pay type) OSPS.99.27  Code Request Form
LWOP leave without pay payment OSPS.99.24  Payment Notification Form
Online reports access OSPS.99.30  Electronic Report Access Request - OSPS
Pay advance request 75.45.02.FO  Emergency Pay Advance Request
Pay back a negative (employee or vendor) OSPS.99.24  Payment Notification Form
Reissue a W-2 tax statement OSPS.99.04  W-2 Reprint / Reissued Statement Request
Release a paycheck early OSPS.99.16  Early Paycheck Release Form
Replace a lost check - under $50 or more than 90 days old
OSPS.99.03  Lost Check Replacement Form
Replace a lost check - over $50 and less than 90 days old C-27  Stop Payment Request
Reports access OSPS.99.30  Electronic Report Access Request - OSPS
Request a manual check No form - see service page 
Research old payroll records OSPS.99.26  Payroll Historic Record Access Request
Resident alien status determination OSPS.99.01  Foreign National Residency Determination
Return an overpayment OSPS.99.24  Payment Notification Form
Return check previously reported as lost OSPS.99.23  Cancel An OSPS Issued Check
Rewrite a vendor check OSPS.99.23 Cancel An OSPS Issued Check
Salary advance request 75.45.02.FO  Emergency Pay Advance Request
Self-pay insurance premiums OSPS.99.24  Payment Notification Form
Send back a check (payroll vendor or employee) OSPS.99.23  Cancel An OSPS Issued Check
Send payment to OSPS OSPS.99.24  Payment Notification Form
Cancel an existing direct deposit - employee OSPS.99.25  Direct Deposit Form (Sign up, Cancel, Suspend)
Stop an ACH electronic deposit - payroll OSPS.99.07  ACH Stop / Reversal Request
Work schedule code request OSPS.99.27  Code Request Form
 
  

Working with Employee Checks
Forms in this section deal with manual activity regarding checks payable to employees.
 
 Number Title
75.45.01.FO  Authorized Signatures
OSPS.99.23  (Cancel) Reverse Employee Check
OSPS.99.16  Early Check Release 
OSPS.99.22  Forged Check Affidavit
OSPS.99.23  Found a Replaced Check
OSPS.99.03  Lost Check Replacement 
 -- Use this for checks that are under $50.00 or that are more than 90 days old.
   Redeemed Check Copy Request (doc)
 -- This is an Oregon State Treasury form link
 C-27  Stop Pay Request (pdf)
-- Use this for checks that are $50.00 or more and that are less than 90 days old.
-- This is an Oregon State Treasury form, modified for use by OSPS agency partners.  NOTE:  Treasury will not accept hand-written forms.
  
  

Working with Vendor Checks cut through OSPA
Forms in this section deal with activity regarding payroll checks not payable to employees.
 
 Number Title
 OSPS.99.23  Cancel & Rewrite a Vendor Check 
 OSPS.99.03  Lost Check Replacement 
 OSPS.99.24  Vendor Negative Repayment 
 
  


Other OSPS Service Requests
Forms in this section deal with all other OSPS services not specified above.
 
 Number Title
 OSPS.99.07  ACH Stop 
 OSPS.99.25  Auth for Cancelation or Reinstatement of Elec Deposit
   Corrected W-2s
 -- Links to service menu instructions
 OSPS.99.33  Garnishment Code Request Form 
 -- Also child support codes, levies, etc.
 OSPS.99.30  Online Payroll Labor Cost Reports Authorization 
 OSPS.99.30  Online Payroll Reports Authorization 
 OSPS.99.24  Return of Overpayment  (paying negative balances)
 -- Also submitting self pay insurance payments
 OSPS.99.13  Social Security and Medicare tax Certification 
 OSPS.99.27  Work Schedule Code Request 
 
  


 
Numerical Sort
All forms pdf unless indicated otherwise.
Forms sorted by form number.  See also "Alphabetical" and "Function" for additional sort options.
 
Form Number
Form Name
Last Updated
75.45.01.FO  Authorized OSPA Signatures April 2011
75.45.02.FO  Emergency Pay Advance Request May 2011
75.45.02.FO.AGY  Emergency Pay Advance Request - Agency Wrapper (doc) April 2011
C-27  Stop Payment Notification September 2013
OSPS.99.01  Foreign National Residency Determination August  2008
OSPS.99.03  Lost Check Replacement Form June 2011
OSPS.99.04  W-2 Reprint / Reissued Statement Request January 2013
OSPS.99.07  ACH Stop / Reversal Request April 2011
OSPS.99.13  Tax Refund Certification April 2011
OSPS.99.16  Early Paycheck Release Form April 2011
OSPS.99.19  Pay Card Form (Sign up or Cancel) March 2012
OSPS.99.22  Forged Check Affidavit November 2010
OSPS.99.23  Cancel An OSPS Issued Check May 2012
OSPS.99.24  Payment Notification Form March 2012
OSPS.99.25  Direct Deposit Form (Sign up, Cancel, Suspend) June 2013
OSPS.99.26  Payroll Historic Record Access Request April 2011
OSPS.99.27  Code Request Form (except for garnishments) January 2014
OSPS.99.28  OSPA System Transaction Entry Request April 2011
OSPS.99.30  Electronic Report Access Request - OSPS July 2011
​OSPS.99.33 ​Garnishment Code Request Form ​January 2014
W-4  Withholding Allowances IRS Form W-4 Updated Annually

 
Other Payroll/Benefit Forms
These links all belong to other payroll-related entities.  These links are provided for your convenience.  This content is not controlled by OSPS.

 Description Responsible Party 
 Parking Forms   Fleet & Parking Services
 PEBB Employer Forms  PEBB
 PERS Employer Forms  PERS 
 Treasury Direct / Savings Bonds  U.S. Treasury