Request for Draw Form
Payroll Clerk’s Initials:
Date of Last Draw:
Immediate Supervisor Signature
Executive Director Signature
I REQUEST A DRAW ON MY WAGES FOR HOURS EARNED.
I further understand that if payroll inadvertently generates another check on our regular payroll run for the same
days covered on this draw and I accept and cash the erroneous check and don’t report it to payroll, it will be
considered theft and disciplinary action, up to termination, will ensue.
DRAWS WILL ONLY BE DONE ON NON-PAYROLL FRIDAYS.
Draws due by Thursday at 10:00 AM