Section Z - Index

For the Position Control Roster Listing for Departments, please refer to Reports in Mobius. If you need access to Mobius, please contact DSA@sco.ca.gov.   

Section D now contains all of the D-1 Index Samples originally included in Section Z.

•  Please see Section D for all D-1 Index Payroll Adjustment Notice - Form STD. 674 Samples

E-1 Index NDI Salary Conversion Tables    

• E-1A Civil Service BU-6, Non-Annual Leave
• E-1B Non-Represented and All Civil Service BU Except BU 6, Non-Annual Leave  (revised 09/2019)
• E-1C California State University Non-Represented M80, M98, C99 and BU 1, 2, 4, 5, 6, 7, 9, 10, 13, 14  (revised 05/2018)
• E-1D California State University BU 3, 8, 11, and E99  (revised 05/2018)

E-2 Index NDI – STD. 674D Samples

• E-2 Sample 1 NDI and Regular Pay
• E-2 Sample 2 NDI Pay
• E-2 Sample 3 Additional NDI Pay
• E-2 Sample 4 Regular/NDI/Full Supplementation Annual Leave
• E-2 Sample 5 NDI Pay for Two Positions Serial Change Only
• E-2 Sample 6a and 6b NDI Pay for Two Positions with Change in Class and/or Unit
• E-2 Sample 7 NDI for Semi Monthly
• E-2 Sample 8 Working on NDI and Regular Pay in Pay Period
• E-2 Sample 9 Working While on NDI and Regular Pay Reduce NDI Not to Exceed Regular Salary

E-3 Index TD – STD. 674 Samples

Full Supplementation:

• E-3 Sample 1 Full Month on TD Account Receivable Request
• E-3 Sample 2 Partial Month on TD Account Receivable Request
• E-3 Sample 3 Payment Request
• E-3 Sample 4 Hourly Employee
• E-3 Sample 5 Shift Differential in Pay Period

Partial Supplementation:

• E-3 Sample 6 Payment Request
• E-3 Sample 7 Payment Request Shift Differential in Pay Period
• E-3 Sample 8 IDL and TD in the Same Pay Period (STD. 674D)

Miscellaneous:

• E-3 Sample 9 MISCELLANEOUS: IDL and TD in the Same Pay Period (STD. 674) Note:  IDL and TD forms must be submitted as a package.
• E-3 Sample 10 SCIF Amount Changed – Reversal of A/R
• E-3 Sample 11 SCIF Daily Rate Increased – Additional A/R Request
• E-3 Sample 12 Wage Loss
• E-3 Sample 13 SCIF Amount Reduced by Attorney Fees
• E-3 Sample 14 Abatement
• E-3 Sample 15 Full Month on TD A/R Request – Fractional Employee

E-4 Index IDL – STD. 674D Samples

• E-4 Sample 1 IDL and Regular Pay, Full Month Monthly Released
• E-4 Sample 2 IDL and Regular Pay
• E-4 Sample 3 Retro IDL, Regular Pay and Shift Differential
• E-4 Sample 4 Working While on IDL
• E-4 Sample 5 Mid-Month Salary Change
• E-4 Sample 6 Two Injury Dates
• E-4 Sample 7 IDL Alternate Schedule
• E-4 Sample 8 IDL, IDL/S, and TD sup in Same Pay Period

• E-5 Example 1A and 1B Calculation and STD. 674D
• E-5 Example 2A and 2B Calculation and STD. 674D
• E-5 Example 3A and 3B Calculation and STD. 674D
• E-5 Example 4A and 4B Calculation and STD. 674D
• E-5 Example 5 Calculation
• E-5 Example 6A and 6B Calculation and STD. 674D

E-6 Index SDI - STD.674D Samples

• E-6 Sample 1 SDI Supplementation with Regular Pay
• E-6 Sample 2 Working While on SDI
• E-6 Sample 3 SDI Supplementation Only
• E-6 Sample 4 Supplementation Reduced Not to Exceed Gross Possible for SDI Period

• H-1 Transmittal of Controller’s Warrant (CD 155)
• H-2 Index Garnishment Documentation – STD. 639 and STD. 639 CFS Examples  (revised 09/2022)
• H-2 Index Garnishment Examples (1-7)
• H-2 Example 1 STD 639 Ordered assignment of wages for out of state Ongoing Child Support collection.
• H-2 Example 2 STD 639 Modification to court ordered assignment of wages with arrears support due for out of state Child Support collection.
• H-2 Example 3 STD 639 Court ordered assignment of wages with arrears support due for Spousal Support only with Arrears also due.
• H-2 Example 4 STD 639 Modification to Court ordered assignment of wages for Ongoing Spousal Support.
• H-2 Example 4.1 STD 639 Cancel Spousal Support arrears.
• H-2 Example 5 STD 639 Student loan collection, 10% of disposable to be taken each month until total amount has been withheld.
• H-2 Example 6 STD 639 FTB child support collection program.
• H-2 Example 7 STD 639 Earnings withholding order.
• H-2 Example 8 STD 639 Modification to earnings withholding order.
• H-2 Example 9 STD. 674 returning pay for garnishment to be withheld.
• H-2 Example 10 STD. 639 CFS Court ordered assignment of wages for child or family support collected in CA.
• H-2 Example 11 STD. 639 CFS Court ordered assignment of wages with arrears for child or family support collected in CA.
• H-2 Example 12 STD. 639 CFS Earnings withholding order for arrears child or family support collected in CA.
• H-2 Example 13 STD. 639 CFS Modification of court ordered assignment of wages for child or family support collected in CA.
• H-2 Example 14 STD. 639 CFS Cancellation of arrears child or family support collected in CA.
• H-2 Example 15 STD. 639 FTB Earnings withholding order for a semi-monthly employee requesting a specific amount per month.
• H-2 Example 16 STD. 639 CFS Court ordered assignment of wages for Ongoing Child and Spousal Support with arrears collected in CA.
• H-2 Example 17 STD. 639 CFS Cancelling Ongoing Child Support collected in CA for a semi-monthly employee.
• H-3 Undeliverable U.S. Savings Bond(s) (PR358)
• H-4 Return of U.S. Savings Bond(s) (PR468)
• H-5 Detail Transaction Report
• H-6 Parking Adjustment Notice (PPSD 360)
• H-7 Form PPSD 360 Completion Instructions
• H-8 Long Term Disability Insurance 60-Day Enrollment Eligibility Notice
• I-1 Index Accounts Receivable STD. 674A/R Samples
• I-1 Sample 1 Regular Pay Accounts Receivable
• I-1 Sample 2 Payroll Deduction A/R Reversal
• I-1 Sample 3 Agency Collection A/R Reversal
• I-1 Sample 4 Change Method of Collection – Agency to Payroll
• I-1 Sample 5 Change Method of Collection – Payroll to Agency
• I-1 Sample 6 Over-Collections of Payroll Deduction A/R
• I-1 Sample 7 Payroll Deduction A/R – Equal Amounts from Multiple Pay Periods
• I-1 Sample 8 8A, 8B Payroll Deduction A/R Package – Specific Pay Period Order
• I-1 Sample 9 9A, 9B Payroll Deduction A/R Package – Specific Accounts from Multiple Pay Periods
• I-3 W-2 Wage & Tax Statement Letter  (revised 01/2023)
• I-4 W-2 Wage & Tax Statement Letter  (revised 01/2023)
• I-5 Statement of Earnings and Deductions  (revised 01/2023)
• I-6 Direct Deposit Advice  (revised 01/2023)
• I-7 Tax and Wage Reporting for Independent Contractors Reclassified as Employees – Sample Letter  (revised 01/2023)
• I-8 Warrant for Deceased Employee – Sample Letter  (revised 01/2023)
• I-9 IRS Notice of Employer Identification Number Assigned  (revised 01/2023)
• I-10 Deceased Employee Data (PPSD 21)  (revised 01/2023)
• I-11 Deceased Employee Data (PPSD 21) (Reverse)  (revised 01/2023)
• I-12 Form W-2 Reporting – Charts I, II, III, IV  (revised 01/2023)
• N-2 Fringe Benefit Processing and Special Accounting Period  (revised 01/2023)