YELLOW BANKRUPTCY - Member Proof of Claims Information
Please provide the following information to assist the Union in filing a claim in the bankruptcy court for unpaid wages and benefits owed to you by Yellow.
Sign in to Google to save your progress. Learn more
Email *
LOCAL UNION NO. *
APPLICABLE CONTRACT/REGIONAL SUPPLEMENT
DEBTOR (EMPLOYER) *
EMPLOYEE NAME *
First Name, MI, Last Name, Suffix
POSITION/JOB CLASSIFICATION *
(i.e. Road Driver, Local Cartage Driver, Mechanic, Clerical, etc.)
WAGE RATE *
STATUS *
(i.e. Full-Time, Part-Time, Casual, Workman's Comp, On-the-Job Injury, etc.)
YEARS OF SERVICE *
(Seniority Date i.e MM/DD/YYYY)
ACCRUED UNUSED VACATION PAY *
Please enter hours. If there is none, please enter zero (0)
ACCRUED UNUSED SICK PAY *
Please enter hours. If there is none, please enter zero (0).
OTHER OUTSTANDING PTO
IF YOU FILED A GRIEVANCE AGAINST YELLOW THAT IS UNRESOLVED, DESCRIBE THE GRIEVANCE , GIVE THE ESTIMATED DATE OF OFFENSE, AND ESTIMATE THE MONETARY VALUE OF THE GRIEVANCE. (i.e. 1.) Unpaid Vacation, August 5 2023, 3 weeks vacation pay; 2.) Using non-union temp work, August 6 2023, backpay 2-3 weeks) 
Please enter the total value if known.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report