I/N Forms

I/N Benefits Documentation

Money Request Form

Use this form when requesting money from the union. Please fill it out and turn it into the Executive Board at least one month prior to the event.

Voucher for Lost Time and Expenses

Right click and “Save As” to your Desktop. When finished email to Financial Secretary and Treasurer.

How to fill out at Lost Time Voucher:

1.  Fill out Name, Select County from drop down, Dept, Clock # and Period Covered (unless this is your first time being paid by the union, then you will need to fill out everything).

   1. The union will always make you whole. If your normal schedule is a 12 hour shift, we will pay you the 12 hours, just split into 8 and 4 hours with appropriate rates.
   2. If you are gone on a day that you are scheduled off, please put 4 hours for Hours Lost.
   3. We do not pay for preshift.
   4. Your only options for Hours Lost are: 4, 8 or 10.
2. Enter the Date, Hours Lost, Rate per Hour, and Reason for the lost time.

3. When filling out the Work Schedule portion, please put the hours you were supposed to work on the day you were supposed to work it (There should be an 8 or 12 on the Date and Shift that you are scheduled).

4. All other items go under the (Non-Taxable) Expense Voucher section.

   1. If you get per diem, the rates are: $62 or $36.50. If you are staying overnight the first night, you will claim $62 on the first day. If you are gone for less than half a day or traveling back, you will claim $36.50.
   2. If you choose, you can keep all food receipts and turn them in for the exact amount (although will not pay more than $62/day as this is an international guideline).
   3. All items, except per diem, that you claim in this section need to be accompanied by a receipt or will not be granted.
   4. Mileage rate is 54.5 cents. Miles will be from the union hall (110 S. Harris, New Carlisle, IN 46552) to/from the destination.

5.  If emailing, please send to Kristy Frantz (kristy.frantz@usw9231.com) and Mike Kienitz (michael.kienitz@usw9231.com) or you can hand in everything to one of us.

6. We do our best to have you paid by the next pay period after we receive the voucher.

Please use this voucher form: