CLAIM FOR ADDITIONAL HOURLY PAY ACTUAL ATTENDANCE

DATE TIME NATURE OF WORK ENTER OVERTIME OVERTIME OVERTIME UNSOCIAL UNSOCIAL AUTHORISATION DETAILS
CO FOR TIME & DOUBLE SINGLE HOURS ON HOURS NOT
FROM TO CALL HALF STANDBY ON STANDBY
OUT HRS HRS HRS MINS HRS HRS
DEPARTMENT-
MINS MINS MINS MINS

SECTION –
EMPLOYEE NAME (BLOCK CAPITALS)

EMPLOYEE SIGNATURE

PAYMENT AUTHORISED (SIGNATURE)

STAND BY CLAIM TOTAL DAYS

DATE & TIME PAYMENT NO. OF

RATE DAYS
FROM TO
MON-FRI
SATURDAY

BANK HOL/

SUN
MON-FRI
SATURDAY
BANK HOL/

SUN
EMPLOYEE TOTAL TOTAL TOTAL TOTAL TOTAL BANK HOL/
PAY NO. OVERTIME OVERTIME OVERTIME UNSOCIAL UNSOCIAL SUN
N.B. CLAIMANTS ENTER PAY NUMBER AND TIME & HALF DOUBLE SINGLE HOURS (20%) HOURS (25%)
TOTAL FOR ADDITIONAL PAYMENTS ON THIS PAYROLL USE ONLY
LINE Standby Allowance £90 per week
Standby day rates - £10 M-F, £20 Sat Sun, Bank
Hols
1 0 8 0
Q
CALL OUT ON CALL OUT NOT CALL OUT TOTAL STANDBY TOTAL TOTAL
N.B. PLEASE NOTE THAT CLAIMS MUST BE STANDBY ON STANDBY NOT DAYS STANDBY STANDBY DAYS
SUBMITTED ON OR BEFORE THE FIRST A B ON STANDBY MON-FRI DAYS SUN/BANK HOL
C SAT
WEDNESDAY AFTER THE LAST SUNDAY IN THE
MONTH OF THE CLAIM 0 0 0 0 0 0 0 0 0 0 0 0

Created on 08/03/2021 09:53:00 Page 1 of 1 EWD316802