Payroll Claim Form

This form will help us to better serve you and give a more prompt response to your Payroll Claim. Please fill it out to the best of your ability. Please fill it out for one claim at a time. If there are more than one Claim please fill it out for as many Claims as you would like to forward to us.

What is your Contact Number?

Hotel Name

What is the Check #?

What is the date of the payroll?

YYYY

What is the Specific Issue

More Information

Please indicate the days worked Eg. ''11/01, 11/02,11/03'' (November 1-3)

What were the hours worked Eg. ''11/01: 9am-5pm; 11/02: 10am to 6pm''

If you answered, "My Pay Rate is Wrong'' which Position was incorrectly compensated? How much should the Rate have been? For Example, "Housekeeping, 11.50$/hr"

Additional information