Payroll Status Change - PDF Version - PAS Associates 2026

1. Click ‘Get Form’ to open the Payroll Status Change form in the editor.
2. Begin by entering the COMPANY NAME and EFFECTIVE DATE at the top of the form. This information is crucial for record-keeping.
3. Fill in your NAME and PAYROLL # in the designated fields to identify yourself within the payroll system.
4. If applicable, provide your NEW ADDRESS, including STREET, CITY, STATE, and ZIP code. This ensures that all correspondence is sent to the correct location.
5. Indicate whether this change is for a new employee or an existing one by checking the appropriate box.
6. Complete the SOCIAL SECURITY NO. and DATE OF BIRTH fields as required for identification purposes.
7. Specify your JOB DEPARTMENT, SHIFT, and PAY details to reflect any changes accurately.
8. Select a REASON FOR CHANGE from the provided options by checking the relevant box. If none apply, you can write a brief explanation in the comments section.
9. For leave of absence details, indicate if it is charged to vacation by selecting YES or NO.
10. If advance pay is requested, check YES or NO accordingly. Fill in any additional comments regarding dates or approvals as necessary.
11. Finally, ensure that you have an APPROVAL signature before submitting your completed form.

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