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Employee Payroll and Benefit Forms
Timesheet Template ​Timesheet template for non-exempt employees.
Health Service Timesheet Template ​Timesheet template for health services employees.
Exempt Management Timesheet Template ​Timesheet template for exempt management employees.
Overtime Authorization Form ​Overtime Authorization.
AFSCME Sec Plus Flex Schedule Form ​Flex Schedule form.
Officer of the Day Accrual and Leave Use Form ​This form and instructions are for managers (not eligible for overtime) to use when they are assigned "officer of the day" duty. It is attached to DOC policy 40.2.2. Officer of the day leave cannot be processed unless this form is attached to the timesheet for the month they serve the duty. Duty duration for officer of the day assignments consist of seven (7) 24 hour periods. The manager serving the duty will receive 8 hours of leave (OD) for each 7 days of duty (ODA).
W-4 Form
Employee Withholding Allowance Certificate
This is the IRS W-4 form. Employees use this form to make changes to their payroll tax exemptions. If you want different amounts deducted for your federal and state income taxes, fill out a separate form for each and note at the top "FEDERAL" or "STATE". For additional information, contact your personal tax advisor. Once filled out, please send this form to your agency payroll contact as soon as possible.
Payroll Advance Form (pdf)

This is the State of Oregon Payroll Advance form. Eligible employees may qualify for an emergency payroll advance of 60% of wages earned to date, less any court-mandated deductions. Once filled out, give this form to your supervisor for approval. Your supervisor will send this form to your agency payroll contact for final approval and to process the payroll advance request. There is a 24-48 hour turnaround to receive the payroll advance if approved.
Payroll Direct Deposit Form (pdf)
This is the State of Oregon Payroll Direct Deposit form. Employees may have up to 4 fixed deposits (specific dollar amounts) and 1 net deposit (balance of your net check). Virtually all banks and credit unions participate in Direct Deposit. Check with your co-workers... you´ll find that 72% of State of Oregon employees participate in Direct Deposit. Once filled out, please send this form to your agency payroll contact as soon as possible.
Accela Pay Link ​Accela Pay Form for pre-paid VISA card.
Oregon College Savings Plan ​Oregon College Savings Plan.
Social Security Card
Request Form
This is the Social Security Card Request form. Use this form to apply for a social security card, or to request a copy of your social security card. This form must be taken in to your local Social Security Office with the necessary documentation to complete your request.
Employee Emergency Information Form (pdf) This is the Employee Emergency Information form. Use this form to change your emergency contact information. Once filled out, please send this form to your agency Personnel Records contact as soon as possible.
Understanding Your State of Oregon Paycheck (doc)
This information will help you better understand your State of Oregon Paycheck or Direct Deposit Stub.

Assurant
Life Insurance Form 
(pdf)Institution employees only

 

This form is used by employees in a "police & fire" classification. Mandatory Occupational Coverage is provide at no cost to the employee.  There is an option for eligible employees to purchase additional group coverage. Once filled out, please send this form to your agency payroll contact as soon as possible.
Assurant_Coverage_Brochure (pdf)​ ​Assurant Insurance information.
Assurant_Medical_History (pdf)​ ​This is the form you will need to fill out if you wish to increase your coverage after the initial 60 days of coverage.
Assurant (formerly Fortis) Life Insurance Policy (pdf)​ ​This is the Fortis Life Insurance policy, which can answer questions regarding your Fortis life insurance.
AFSCME Security Vacation Payout Form  AFSCME Security Vacation Payout Form.
AFSCME Security Plus Comp Time Payout AFSCME Security Plus Comp Time Payout Form.
AOCE Vacation and Comp Time Payout Form AOCE Vacation Payout Form.

Police and Fire form

OPSRP employees not eligible​

P & F Units Applications for purchasing or increasing units. This is an option for Tier 1 and Tier 2 Police and Fire employees only.
 

Additional Links
DAS Payroll Services Forms 
Oregon Department of Revenue 
American Payroll Association US Department of Labor -
Wage and Hour Division
 
Internal Revenue Service US Department of Labor -
Wage and Hour Division - Youth
 
US Savings Bonds 
Social Security Online
   
 
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