CHANGES FOR EXISTING SPECIAL DUTY JOB REQUESTS
IF YOU NEED TO CANCEL YOUR JOB DURING NON BUSINESS HOURS PLEASE CALL: 1-800-916-1383 AND FAX A COPY OF
THIS COMPLETED REQUEST FORM TO: (808)-768-1699 PLEASE PRINT LEGIBLY
Phone: (808) 723-3575
Fax: (808) 768-1699
Email: specialduty@honolulu.gov
Company or Individual's Name:
Phone #:
Fax #:
Job 01 Job 02 Job 03 Job 04 Job 05
Cancel Job 01 Cancel Job 02 Cancel Job 03 Cancel Job 04 Cancel Job 05
Info
Original
Order
Change
Original
Order
Change
Original
Order
Change
Original
Order
Change
Original
Order
Change
HPD #
Job Date
Amt Of
Officers
Start Time
End Time
Total Hours
Equipment
Rank
Payment Type
Officer Rate
Job Location:
New Location Job 02:
New Location Job 01:
New Location Job 03:
New Location Job 05:
New Location Job 04:
I understand and agree that I must follow all current Special Duty policies. I understand and agree to pay the officer's fee directly to the officer
assigned and any other fees (equipment, mileage, administrative, and workers compensation) associated with my request to The City & County of
Honolulu. I understand that officers participate in the Special Duty Program on a voluntary basis and that there is no guarantee that my request will be
filled. It is my responsibility to follow up with the Special Duty Section, during normal business hours, to determine if my changes have been received.
I understand that there is a 2-hour minimum fee for special duty assignments. If I do not notify the Special Duty Section of the cancellation in writing
24 hours prior to the start of the assignment, I will be assessed the fee for each officer I requested.
Print Name:
Date:
Requestor's Signature:
Contact Name:
Email:
Additional Comments
SD-2 (R-10/2012)
