Umpire Payment Request

Umpire Payment Request
Welcome to the Stateline Sports Group Umpire Payment Request.

Please complete this form in full and submit it once finished. Stateline Sports Group processes umpire payments twice per month.

Before any payment requests are processed, you must have a current W-9 on file.

Requests made between the 15th and the last day of the prior month are paid on the 15th of the current month.

Requests made between the last day of the prior month and the 15th of the current month are paid on the 30th of the current month.

Thank you for your time and for being part of Stateline Sports Group.
DateTime
No I have submitted BeforeYes this is my first request for paymentt
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Date You Umpired

MonthDayYear
Date
Number of Games Umpired
Total Payment ($55.00 per game)
Should be Empty: