WPC  77WPC >?wA= ?EU @?N?Owj?'k= *<$J^onZ7>   (  (Untitled)'3,h , ,   UB ) 3    *     +     ,     /0gjklmnopqrstuvwxyz{|}~<* * f:\inf41\forms\ad343.wpf c:\inf41\forms\ad343.wpf&& &&   >t?f eh Terminal 1 ! ZS  d      Terminal eb Arial " ! <S  d    Arial ev Times New Roman  ! <S  d    Times New Roman ex Helvetica-Narrow " ! (5 S  d    Helvetica-Narrow eb Roman  ! 2L   d    Roman eh Helve-WP " ! <S  d     Helve-WP ej Wingdings  ! S  d     Wingdings eX  ! <S  d     eh MS Serif  ! <S  d     MS Serif ed Modern 2 ! x."  d    Modern ej Bodoni-WP  ! <S  d     Bodoni-WP er MS Sans Serif " ! FS  d    MS Sans Serif ed System " ! Z@   d    System en Courier New 1 ! PL5    d      Courier New er CG Times (WN)  ! <S  d    CG Times (WN) ef Courier 1 ! ZS  d     Courier en Univers ATT " ! FS  d     Univers ATT ep Times CG ATT  ! <S  d     Times CG ATT ep Arial Narrow " ! (5 S  d     Arial Narrow ez WP IconicSymbolsB  ! Z."j  d    WP IconicSymbolsB ?Ad A{?Ez jV c:\inf41\database\ AD343.DBFhistory   i&SeqNo     h SEQNO i&Date1     h DATE1 i$PP1     h PP1 i&Date2     h DATE2 i$PP2     h PP2 i)AgcyCode     h AGCYCODE i&OfcID     h OFCID i)AcctCode     h ACCTCODE i'AgcyNm  -   h AGCYNM- i$AD1  -   h AD1- i$AD2  -   h AD2- i%CITY  -   h CITY- i&STATE     h STATE i$ZIP     h ZIP i(EmpCont  0   h EMPCONT0 i'Exempt      h EXEMPT  i'NonExe      h NONEXE  i)RetireCd  0   h RETIRECD0 i%Full      h FULL  i'Interm      h INTERM  i&ReEmp      h REEMP  i%Part      h PART  i(First40      h FIRST40  i$SSN     h SSN i(EmpName  -   h EMPNAME- i'ACTION      h ACTION  i'TermNo      h TERMNO  i(TermYes      h TERMYES  i)DateTerm     h DATETERM i*MailAddr1  7   h MAILADDR17 i*MailAddr2  7   h MAILADDR27 i*MailAddr3  7   h MAILADDR37 i*MailAddr4 ! 7   h MAILADDR47 i*MailAddr5 " 7   h MAILADDR57 i)EXPLAIN1  #    h EXPLAIN1  i)EXPLAIN2  $    h EXPLAIN2  i'AMOUNT %    h AMOUNT i)AcctData  &    h ACCTDATA  i(SupAuth  '    h SUPAUTH  i(Contact ( =   h CONTACT= i&PHONE )    h PHONE i%SIGN * =   h SIGN= i(DateSgn +    h DATESGN i)AuthSign , =   h AUTHSIGN= i&TITLE  -    h TITLE  i'DateAp .    h DATEAP i'ROUTE1 / -   h ROUTE1- ?e@d @}?NgxV,,  ' A !"#                             <  &     g,  ' ? !"#                             <       ^, ( PAYROLL ACTION REQUEST , !"#                            <  &&    l^  1.  !"#                            <  &       d PERSONNEL OFFICE  d SEQUENTIAL REQUEST NUMBER  !"#      n                      <  &&    ^6  2. ADJUSTMENT PERIOD (Inclusive) /" !"#                            <  &&    n&4 1 FROM / !"#                            <  &&    lF&  TO @ !"#                            <  &&    E d DATE Date1!"-./5/67 89: ;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     3@HASVALUE (Date1) and #UPDATONLY    Date1  ~      8@datevalue (@datetext (Date1, "%2-%1-%5"))   Date1   %2-%1-%5  "  #  5@VALUE (@DATETEXT (Date1,"%5"))<=29   Date1   %5  "  x         r@SETVALUE (Date1,@DATEVALUE (@CONCAT (@DATETEXT (Date1,"%2-%1"),"-20",@DATETEXT (Date1,"%5"))),TRUE)   Date1   Date1   %2-%1  "   -20   Date1   %5  "      #       @X d P/PX PP1!"-./5;6789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     EF d DATE Date2!"-./5@67 89: ;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     3@HASVALUE (Date2) and #UPDATONLY    Date2  ~      8@datevalue (@datetext (Date2, "%2-%1-%5"))   Date2   %2-%1-%5  "  #  5@VALUE (@DATETEXT (Date2,"%5"))<=29   Date2   %5  "  x         r@SETVALUE (Date2,@DATEVALUE (@CONCAT (@DATETEXT (Date2,"%2-%1"),"-20",@DATETEXT (Date2,"%5"))),TRUE)   Date2   Date2   %2-%1  "   -20   Date2   %5  "      #       @"$& d P/P& PP2!"-./5M6789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     ^~X  INSTRUCTIONS ON REVERSE OF AGENCY COPY   PLEASE READ CAREFULLY , !"#                            <  &&    r~6  4. FROM /" !"#                            <  &&    MF d AGENCY CODE AgcyCode!"-./5/67 89: ;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     hF d PERSONNEL OFFICE  d IDENTIFIER OfcID!"-./596789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     Tf!F d ACCT. STATION CODE AcctCode!"-./5G67 89: ;>?@ABCG                         < #    Z $    Z '   Y@$.,! *  < && = &&     _6 d AGENCY NAME AND MAILING ADDRESS6 AgcyNm! "-./5/67"89:";>?@ABCG                         < #     $     ' -  Y@$.,! *  < && = x&     ,f6 AD1! "-./5/6 7"89:;>?@ABCG                         < #     $     ' -  Y@$.,! *  < && = x&     ,. 6 AD2! "-./5/6 7"89:;>?@ABCG                         < #     $     ' -  Y@$.,! *  < && = x&     B  d CITY CITY! "-./5/6 789:;>?@ABCG                         < #     $     ' -  Y@$.,! *  < && = x&     F  d STATE STATE! "-./25A6 789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     E  x d ZIP CODEx ZIP!"-./5F6 7 89: ;>?@ABCG                         < #     $     '    Y@$.,! *  < && = &&     a 6 d 5. EMPLOYEE'S T&A CONTACT POINT6 EmpCont!"-./5/67"89:";>?@ABCG                         < #     $     ' 0  Y@$.,! *  < && = &&     r 6 d 6. FLSA /" !"#                            <  &&    z , (     Exempt#$%/&'()+,-.                            <   !  * && 1  2     3       @RESETOBJ (NonExe)   NonExe    j   d EXEMPT 1 !"#                            <  &&    z , (     NonExe#$%9&' ()+,-.      d                      <   !  * && 1  2     3       @RESETOBJ (Exempt)   Exempt    n L d NON-EXEMPT ;  !"#                            <  &&    F  (   U.S. DEPARTMENT OF AGRICULTURE  ( NATIONAL FINANCE CENTER  ( PO BOX 60000  ( NEW ORLEANS, LA 70160   # !"#      n                      <  &&     V^        <    }66 d 8. TYPE EMPLOYMENT /" !"#                            <  &&     (     Full#$%/&'()+,-.                            <   !  * && 1  2     3      (     Interm#$%9&'()+,-.                            <   !  * && 1  2     3     @ (     ReEmp#$%A&' ()+,-.                            <   !  * && 1  2     3     R, d INTERMIT-  d TENT ; !"#      Z                      <  && $    ??O h^ d REEMPLOYED  d ANNUITANT D  !"#                            <  && $    | , d FULL-  d TIME 1 !"#      Z                      <  && $    , (     Part#$%/&'()+,-.                            <   !  * && 1  2     3     x, (     First40#$%9&' ()+,-.                            <   !  * && 1  2     3     , d ALTERNATE  d WORK SCHEDULE ;  !"#      Z                      <  &&    | * d PART-  d TIME 1 !"#      Z                      <  &&    n^: d 9. SOCIAL SECURITY NO.: SSN!"-./56789:;>?@ABCG                         < #     $     ' --  Y@$.,! *  < && = &&     z  d 10. EMPLOYEE'S NAME (Last, First, Middle Initial)z EmpName!"-./56789:;>?@ABCG                         < #     $     ' - - -   Y@$.,! *  < && = &&     s^$ d 11. NATURE OF ACTION TO BE TAKEN ACTION!"-./567,89:,;>?@ABCG                         < #     $     '  - - -   Y@$.,! *  < && = x&     y$ d 12. TERMINATED / !"#                            <  &&     (     TermNo#$%/&'()+,-.                            <   !  * && 1  2     3      @RESETOBJ (TermYes);@RESETOBJ (DateTerm);@RESETOBJ (MailAddr1);@RESETOBJ (MailAddr2);@RESETOBJ (MailAddr3);@RESETOBJ (MailAddr4);@RESETOBJ (MailAddr5)    TermYes     !  DateTerm     "  MailAddr1     "  MailAddr2     "  MailAddr3     "  MailAddr4     "  MailAddr5     (     TermYes#$%9&'()+,-.                            <   !  * && 1  2     3       @RESETOBJ (TermNo)   TermNo    g d YES ; !"#                            <  &&    j$ d IF YES > !"#                            <  &&    f  d NO 1 !"#      Z                      <  &&    S$: d DATE TERMINATED: DateTerm!"-./5B6789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     6@HASVALUE (DateTerm) and #UPDATONLY    DateTerm  ~      ;@datevalue (@datetext (DateTerm, "%2-%1-%5"))   DateTerm   %2-%1-%5  "  #  8@VALUE (@DATETEXT (DateTerm,"%5"))<=29   DateTerm   %5  "  x         {@SETVALUE (DateTerm,@DATEVALUE (@CONCAT (@DATETEXT (DateTerm,"%2-%1"),"-20",@DATETEXT (DateTerm,"%5"))),TRUE) !  DateTerm   DateTerm   %2-%1  "   -20   DateTerm   %5  "      #       TermNo=true   TermNo       #@ALLOWEDIT (DateTerm) !  DateTerm     @NOEDIT (DateTerm) !  DateTerm  )  ^  d 13. EXPLANATION OF CIRCUMSTANCES WHICH REQUIRE THIS ACTION EXPLAIN1!#"-./567,89:,;>?@ABCG                         < #     $     '  - - -   Y@$.,! *  < && = x&     s6 d CHECK MAILING ADDRESS OR DESIGNATED AGENT NUMBER6 MailAddr1!"-./5/67"89:";>?@ABCG                         < #     $     ' 7  Y@$.,! *  < && = x&     TermNo=true   TermNo       $@ALLOWEDIT (MailAddr1) "  MailAddr1    !@NOEDIT (MailAddr1) "  MailAddr1  )  a6 d 14. GROSS AMOUNT OF ADJUSTMENT6 AMOUNT!%"-./5/6 7"89:";>?@ABCG                         < #     $     '    $.,! *  < && = &    C^&$f EXPLAIN2!$"-./56"7N8 9:;>?@ABCG                         < #     $     '  - - -   Y@$.,! *  < && = x&     ^#$  d 15. ACCOUNTING DATA TO BE CHARGED AND/OR CREDITED$ AcctData!&"-./56-7N89:N;>?@ABCG                         < #     $     '  - - -   Y@$.,! *  < && = x&     ^&$ d 16. ATTACHMENTS SUPPORTING OR AUTHORIZING THIS ACTION$ SupAuth!'"-./5617N89:N;>?@ABCG                         < #     $     '  - - -   Y@$.,! *  < && = x&     w^\+X d 17. PERSON TO BE CONTACTED FOR ADDITIONAL INFORMATION Contact!("-./5677,89:,;>?@ABCG                         < #     $     ' =  Y@$.,! *  < && = x&     w\+X d TELEPHONE (Area Code and Number) PHONE!)"-./5/677"89:";>?@ABCG                         < #     $     '  () -  Y@$.,! *  < && = &&      VH&\+X       <    |^- d 18. EMPLOYEE'S SIGNATURE AND DATE SIGNED (If Required) SIGN!*"-./56:7,89:,;>?@ABCG                         < #     $     ' =  Y@$.,! *  < && = x&     5-6 DateSgn!+"-./5/6:7"89:;>?@ABCG                         < #     $     '    Y@$.,! *  < && = &&     5@HASVALUE (DateSgn) and #UPDATONLY    DateSgn  ~      :@datevalue (@datetext (DateSgn, "%2-%1-%5"))   DateSgn   %2-%1-%5  "  #  7@VALUE (@DATETEXT (DateSgn,"%5"))<=29   DateSgn   %5  "  x         x@SETVALUE (DateSgn,@DATEVALUE (@CONCAT (@DATETEXT (DateSgn,"%2-%1"),"-20",@DATETEXT (DateSgn,"%5"))),TRUE)    DateSgn   DateSgn   %2-%1  "   -20   DateSgn   %5  "      #       w^D/$  19. APPROVAL <N !"#                            <  &&    k^ 0< d AUTHORIZED OFFICIAL'S SIGNATURE AND TITLE< AuthSign!,"-./56=7 89: ;>?@ABCG                         < #     $     ' =  Y@$.,! *  < && = x&     1 0 TITLE!-"-./5#6=789:;>?@ABCG                         < #     $     '  2  Y@$.,! *  < && = &&     Or 0 d DATE APPROVED DateAp!."-./5C6=789:;>?@ABCG                         < #     $     '    Y@$.,! *  < && = &&     4@HASVALUE (DateAp) and #UPDATONLY    DateAp  ~      9@datevalue (@datetext (DateAp, "%2-%1-%5"))   DateAp ??'  %2-%1-%5  "  #  6@VALUE (@DATETEXT (DateAp,"%5"))<=29   DateAp   %5  "  x         u@SETVALUE (DateAp,@DATEVALUE (@CONCAT (@DATETEXT (DateAp,"%2-%1"),"-20",@DATETEXT (DateAp,"%5"))),TRUE)   DateAp   DateAp   %2-%1  "   -20   DateAp   %5  "      #       1l d FORM AD-343 (USDA) (REV. 11/95) A? !"#                            <  &    ^1  d This form was electronically produced by Elite Federal Forms, Inc. ? !"#                            <  &     V-       <     V-}       <    5v6 MailAddr2!"-./5/67"89:;>?@ABCG                         < #     $     ' 7  Y@$.,! *  < && = x&     TermNo=true   TermNo       $@ALLOWEDIT (MailAddr2) "  MailAddr2    !@NOEDIT (MailAddr2) "  MailAddr2  )  5>6 MailAddr3! "-./5/67"89:;>?@ABCG                         < #     $     ' 7  Y@$.,! *  < && = x&     TermNo=true   TermNo       $@ALLOWEDIT (MailAddr3) "  MailAddr3    !@NOEDIT (MailAddr3) "  MailAddr3  )  56 MailAddr4!!"-./5/67"89:;>?@ABCG                         < #     $     ' 7  Y@$.,! *  < && = x&     TermNo=true   TermNo       $@ALLOWEDIT (MailAddr4) "  MailAddr4    !@NOEDIT (MailAddr4) "  MailAddr4  )  56 MailAddr5!""-./5/67"89:;>?@ABCG                         < #     $     ' 7  Y@$.,! *  < && = x&     TermNo=true   TermNo       $@ALLOWEDIT (MailAddr5) "  MailAddr5    !@NOEDIT (MailAddr5) "  MailAddr5  )  D 1  \ route1 ROUTE1!/"-./156?789:;>?@ABCG                         < #     $    d ' -  Y@$.,! *  < && = &&      (f PRINT FORM W/  (G ROUTING ROUTE  0     !"#$%          &&     @SETVALUE(ROUTE1,"NFC",TRUE);@PRINT();@SETVALUE(ROUTE1,"PROCESSING COPY",TRUE);@PRINT();@SETVALUE(ROUTE1,"AGENCY COPY",TRUE);@PRINT();@RESETOBJ(ROUTE1)   ROUTE1   NFC              ROUTE1 &  PROCESSING COPY              ROUTE1 "  AGENCY COPY              ROUTE1      ( PRINT FORM  (9 W/OUT ROUTING NO_ROUTE  1    !"#$%          &&     P@HIDE(ROUTE);@HIDE(NO_ROUTE);@PRINT();@SHOW(ROUTE);@SHOW(NO_ROUTE)   ROUTE  3   !  NO_ROUTE  3         ROUTE  c   !  NO_ROUTE  c  +: SeqNo!"-./56789:;>?@ABCG                         < #     $     '   Y@$.,! *  < && = &&     f^~  3.  !"#                            <  &    ^6 d 7. RETIREMENT COVERAGE CODE6 RetireCd!"-./5/67"89:";>?@ABCG                         < #     $     ' 0  Y@$.,! *  < && = &&     g,,  $ /! !"#                             <       V ^6       <    g " '  !"#                             <  &    ?= def =c<$defg <^o elite10.DLL IVALID FILLER This form was Designed by Elite Federal Forms and requires the Elite/Novell Filler! Call 410-647-9691 for more information. elite10.COM IVALID FILLER This form was Designed by Elite Federal Forms and requires the Elite/Novell Filler! Call 410-647-9691 for more information. WPIN$ELITE10FunctionSet,4.1 ^=Z׊sZ$