Uniform Order and Payroll Deduction Form
This document is essential for employees at Mary Free Bed Rehabilitation Hospital to order uniforms and set up payroll deductions. It ensures that the uniform ordering process is streamlined and manageable. Use this form to authorize deductions from your paycheck for uniform purchases.
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How do I fill this out?
To fill out this form, start by providing your personal details at the top of the document. Next, specify the uniform items you wish to order, including color, size, and quantity. Finally, authorize the payroll deductions by signing at the bottom of the form.

How to fill out the Uniform Order and Payroll Deduction Form?
1
Enter your name and department at the top of the form.
2
List the items you wish to order with their product numbers.
3
Select the color and size for each item.
4
Specify the payment method and total amount.
5
Sign the authorization section and submit the form.
Who needs the Uniform Order and Payroll Deduction Form?
1
New employees who need uniforms for their roles.
2
Department supervisors managing uniform orders for their team.
3
HR personnel responsible for payroll deductions and record-keeping.
4
Employees changing roles requiring new uniforms.
5
Administrative staff overseeing budget allocations for uniforms.
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What are the instructions for submitting this form?
To submit the Uniform Order and Payroll Deduction Form, complete all required fields and sign the document. You can send the completed form via email to hr@maryfreebed.com or fax it to 555-123-4567. Ensure your submission is made prior to the specified deadline to enable timely processing of your uniform order.
What are the important dates for this form in 2024 and 2025?
Important dates related to form submission and payroll deductions will vary, but generally align with payroll schedules. Please consult with your HR department regarding specific deadlines. Timely submission ensures prompt processing of your uniform orders.

What is the purpose of this form?
The Uniform Order and Payroll Deduction Form primarily serves to facilitate the ordering of uniforms for employees at Mary Free Bed Rehabilitation Hospital. This form allows employees to order required attire while setting up automatic payroll deductions for convenience. It is essential for maintaining compliance with hospital uniform policies and ensuring that all staff members are adequately equipped for their roles.

Tell me about this form and its components and fields line-by-line.

- 1. Name: The employee's name must be printed clearly.
- 2. Department: The department in which the employee works.
- 3. Title on Apparel: The title that will appear on the uniforms.
- 4. Phone/Ext #: Contact information for the employee.
- 5. New Hire Start Date: The start date for new employees.
- 6. Logo: Specification for the hospital logo to be used.
- 7. Qty: Quantity of each item ordered.
- 8. Product#: The product number for each uniform item.
- 9. Color: Color options for the requested uniforms.
- 10. Size: Size specifications for each item.
- 11. Cost per item: The price of each uniform item.
- 12. Total: Total cost for the ordered items.
- 13. Check#: For check payment, the check number should be noted.
- 14. Sub Total: Subtotal before deductions or stipends.
- 15. Minus Stipend: Any stipends applicable to reduce the total.
- 16. Grand Total: Final total to be deducted from pay.
What happens if I fail to submit this form?
Failure to submit this form may result in delays in receiving your uniforms. Without timely submission, you may not have the required attire by the time you start your duties. It's crucial to ensure that all details are correct and submitted by the deadlines set by HR.
- Uniform Delays: Not receiving uniforms on time can hinder your ability to fulfill your job requirements.
- Inaccurate Deductions: Incorrect information may lead to improper payroll deductions.
- Non-compliance Issues: Failure to submit the form could create compliance issues with hospital policies.
- Budget Implications: Delays may impact departmental budgeting for uniforms.
How do I know when to use this form?

- 1. New Hires: Used by new employees to order their initial uniforms.
- 2. Role Changes: For employees transitioning to new roles that require different uniforms.
- 3. Uniform Replacements: Employees needing to replace worn or damaged uniforms.
- 4. Additional Orders: When additional uniforms are needed due to workload.
- 5. Departmental Management: Used by department heads to manage uniform supplies.
Frequently Asked Questions
How do I fill out the Uniform Order Form?
Start by entering your personal details and the items you wish to order.
Can I edit this form on PrintFriendly?
Yes, you can edit the PDF directly using the PrintFriendly editor.
How do I authorize payroll deductions?
Sign the authorization section at the bottom of the form.
Is there a deadline for submitting this form?
Check with your HR department for specific deadlines.
What if I make a mistake while filling out the form?
You can edit the PDF again to correct any mistakes.
Can I share this form with my colleagues?
Absolutely! Use the share feature to send them the link.
What payment methods can I use?
You can specify if paying by cash or check in the designated area.
Is a signature required?
Yes, an employee signature is required to authorize deductions.
How will I know my order is processed?
You will typically receive a confirmation from your HR department.
Can I download the filled form?
Yes, once edited and signed, you can download the completed form.
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