Union Cover Form
IAFF Local 1159
Today's Date:
-
Month
-
Day
Year
Date
Date of Cover:
-
Month
-
Day
Year
Date
Member Requesting Cover:
First Name
Last Name
Email of Member Requesting Cover:
example@example.com
Member Providing Cover:
First Name
Last Name
Address of Member Providing Cover
Street Address
Address Line 2
City
State
Zip
Email of Person Providing Cover:
example@example.com
Phone Number of Person Providing Cover:
Please enter a valid phone number.
Shop of Cover:
Please Select
Aurora
Canby
Clackamas
Estacada
Lake Oswego
Molalla
OSFFC - State
Reason For Cover:
Please Select
Conference/Convention
Meeting
Other
Principal Officer Approval:
Please Select
President
Vice President
Treasurer
Secretary
Hours Worked (Rate is $36/hr):
Cover Reimbursement Total:
In order to get reimbursed, you are required to have a IRS W-9 form on file with Local 1159. Please fill out and upload, or email to Treasurer@local1159.
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If you need to download a W-9 form, you can find it at the link below:
W-9 Download Link
Thank you for providing cover so we can work on your behalf for better wages, hours and working conditions!
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