Request for Final Paycheck Form (aka Payroll Separation Check Request Form)

Form Instructions

Example: Monthly staff MSP Employee with 81 MOS.
Separation date is 03/05/2010. 40 hours TOPS 03/01-05/2010 and 160 hours TOPS 02/01-28/2010.


Remaining Accrual Owed to Employee


Leave Type

Current Balance

Prior Period Accrual

Current Period Accrual

Total Hours Paid

(sum of columns)

Vacation Leave





Sick Leave





Comp Time




Before entering any balance information in the table, review the employee’s available timesheets for accuracy (in HBS two timesheets are always available).

  1. Record any usage of vacation, sick, or comp time hours.
  2. If the employee is bi-weekly, delete any work hours after the separation date.
  3. Ensure the Employee complete and Approver approve the timesheets.

Current Balance Column

  1. In HBS, refer to the Current Balance column in the Employee Balances screen.
  2. Enter the numbers from the Current Balance column for each balance group. Example: enter 148.000 for Vacation and 135.990 Sick.

Remaining Accrual Owed to Employee Columns

  1. Determine the prior monthly or 4-week bi-weekly accrual period the employee was on pay status. Example: Employee was on pay status for the monthly pay period of March 2010.
  2. In HBS, check if accruals were provided for that period by reviewing the last Accrual Date. Example: Last Accrual Date is 02/01/2010.
    Example: enter 148.000 for Vacation and 135.990 Sick.
  3. If accruals for the prior period were provided by HBS, enter Not Applicable in the Prior Period Accrual column for each balance group. NOTE: The Current Balance already contains the prior accrual so this prevents double-counting those hours.
  4. If accruals for the prior period were NOT provided by HBS, use the appropriate accrual methodology to calculate the prior period accruals. Refer to the HR Admin Training Manual for more information on accruals.
    Example: Accruals for February 2010 NOT provided (last Accrual Date of 02/01/2010 is for January 2010 earnings). For February: VAC = 12.923 (160 TOPS x .080769 factor) and SKL = 7.384 (160 TOPS x .046154 factor).
    Enter the accruals you calculated for that prior period in the Prior Period Accrual column.
  5. Calculate prorated accruals for the current period (last pay period employee was on pay status).
    Example: For March: VAC = 3.230 (40 TOPS x .080769 factor). No SKL provided because TOPS < 50%.
    1. Enter the accruals you calculated for current period in the Current Period Accrual column.