Questionnaire For Pay Issues

First name

Last name

Phone

1. How long have you been employed by the company?

2. Do you have an employment contract?

Yes

I’m not sure.

3. Please break down the number of DAYS you work a week (e.g., Monday to Friday), and how many HOURS a day. If you work different hours, at different sites, please specify what hours you work for EACH site.

4. What is your hourly rate of pay?

5. Do you take any daily unpaid breaks, and if so, how many minutes?

6. Do you know what period each payroll spans? (e.g., I get paid the 10th of each month, with each payslip covering days worked from the 1st to the 30th of each month).

7. How do you record your hours:

I manually sign my name into a signing in and out sheet.

I use an app to log my hours in and out.

I have never signed in and out, I just tell the supervisor how many hours I have worked.

Other

8. If you work any overtime/do covers, how do you record this?

I just add the hours to the signing in and out sheet.

I just add it to the app system.

I just tell my supervisor the extra hours I have worked via WhatsApp.

Other

9. What your pay issue is (Please specify in the next section):

They have paid me fewer hours than those I have worked. (Specify difference in hours worked vs hours received. (E.g., I worked a total of 155 hours in October, yet my payslip says 120 hours)

They have paid we at a lower rate than my contractual rate. (Specify normal contractual rate. Specify rate at which you have been paid)

They have not paid me cover work/overtime work that I did. (Specify amount of overtime done, on what site, on what days and what evidence you have that this overtime was done (e.g., WhatsApp conversations with the supervisor)

I have had pay deducted for absence, but the absence was authorised/I did attend work. (Provie further details (e.g. if you were off on annual leave, specify the dates, and what evidence you have that these dates were approved)

10. Further information – please add any further information that you find relevant.