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Payroll Discrepancy Form
THIS FORM SHOULD ONLY BE FILLED OUT IF YOU HAVE ALREADY RECEIVED YOUR PAYCHECK.
This form must be filled out within 2 weeks of the pay date.


1.) To ensure accuracy and proper communication, payroll discrepancies will only be accepted in writing through this form.
2.) All fields must be completely filled out. Any information omitted from this form will result in a delay researching your discrepancy.
3.) All discrepancies will be thoroughly investigated.

Only GHPM employees are authorized to submit a payroll discrepancy form. Forms submitted by anyone other than the employee will be rejected and considered invalid.



Required Information
Discrepancy Information
Security Validation
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