Payroll Advance

State

Text Label

An employee can receive advance payment of wages only in a bona fide emergency situation and with approval of their Decision Maker and the Payroll Manager or Designee.

** Approved Requests must be received by the Payroll deadline. **

An approved request for a payroll advance will not be processed after the pay period end date. This means no advance will be given between the window of the Wednesday pay period ending date and the following Friday pay date for hours worked that pay period. Contact HR-Payroll (970-498-5991) if you have any questions about this deadline.

Requests for a payroll advance will not be approved in consecutive pay periods for the same employee.

A payroll advance cannot exceed 75% of the unpaid wages actually earned at the time of the request. Payroll will also review the request to make sure all required benefit and legal deductions are met.

(Lookup Employee by last name first)

Employee Name

Employee #

Department

Employee Email

Date of Request

Amount Requested

Explanation

Text Label

MAXIMUM SALARY ADVANCE COMPUTATION

Hourly Pay

Rate

Actual hours to date

(in current period)

= $

Total Wages Earned to

date (in current period)

Maximum %

Allowed

.75

= $

Maximum

Advance Allowed

Text Label

I understand that the requested pay advance amount will be deducted from my next pay check.

Print Name: *

Employee Signature *

Undo

signature

Date

Decision Makers Email *

Print Name:

Text Label

FOR HR-Payroll USE ONLY:

Approved

Denied

Print Name:

Payroll Manager or Designee Signature

Undo

signature

Date

Reason For Denial:

Text Label

Payroll Deduction Code = PYADV

Approved Amount $

Advance deducted from Pay Check Dated:

PDF

Submit Reset