PAYROLL QUERY FORM

PAYROLL QUERY FORM

NOTE: Please ensure that you do not submit more than one Query Form per pay period. Double or multiple Query Forms will not be processed.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Number of hours paid
Number of hours queried
CALCULATION OF HOURS WORKED
Number of hours paid
Difference being claim
Date

MonthDayYear
Date
Signature
Should be Empty: