JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Payroll Correction Request
If you believe that there may be a mistake on your paycheck, please complete the form below so that we may investigate your request.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
Your answer
What is the best phone number to reach you?
Your answer
What is your email address?
Your answer
Managers Name
Your answer
Department
Your answer
What is the pay date in question?
Your answer
What is the error?
Missing Hours
Incorrect Pay Rate
Missing PTO
Missing Clockin/Clock Out
Other:
Clear selection
Please provide the details of the error:
ie) Correct dates and times of missing clock-in or clock-out, correct pay rate, PTO date(s) etc
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Bald Birds Brewing Company.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
