063e219aff2f11edb8c18eedbd4eb23e

Directions: Please submit one copy per provider requested.

All fields are required for a successful setup of file.

CLIENT CODE SCENARIO

Please work with your provider to find out the correct choice to your plan. By default, Paycom cannot combine files/reports across Client Codes.

(Deviating from these selections may require restarting the project and additional fees. Choose one below.)

Single Client Code — One file per Payroll Transaction

List applicable Client Code:

Client Code Family — One file per Payroll Transaction, per Client Code

List all applicable Client Codes:

Multi-Client Code (MCC) setup (Choose one below)

One file per Payroll Transaction, per Client Code

One combined file per Check Date, produced on Check Date

List MCC and all applicable Client Codes:

FILE REQUEST SCENARIO

New Paycom client — Forecasted 1st Check Date _____ /_____ /________

(Paycom can only start development of file once payroll has been run and client data exists to be tested.)

Existing Paycom client

This is a new report request — Expected Live Date _____ /_____ /________

Provider change (will result in additional $500 setup per Client Code)

Stop date old Provider _____ /_____ /________ Start date new Provider _____ /_____ /________

Adding Client Code(s) to existing report — Expected Live Date _____ /_____ /________

FILE DELIVERY METHOD

(Choose one below.)

Deliver file to Paycom Secure Client Inbox

Secure FTP delivery (auto-feed) to Provider (contingent on Provider)

(Not all providers/custodians can receive files automatically via Secure FTP.)