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9105 : Acknowledgment of Pay Rate for Travel Time
To view (download) the Form, click View Form button >>Open Form
WHEN TO USE
Employers must compensate employees who travel on company business. But, employers need not pay employees their regular rate during that time. Employers may pay a lower rate for travel time during which no work is performed, as long as the rate is at least minimum wage and employees are informed of the lower rate before they travel.

To ensure that employees understand the lower rate before they travel, employers may require employees to sign this acknowledgment of their pay rate for travel time.
HOW TO USE
This Form is in Microsoft Word® (".doc") format. To download it, click on the "View Form" link below or at the top of this page. The Form will open in a word processor, which allows you to customize it. To save the Form on your local drive, click on the "File" menu in your word processor and select "Save As...."

In this Form, bolded text in brackets is used to highlight portions that must be adapted to your situation. Instructions on how to customize the Form are in bold italics, and suggested language is in bold non-italics.
RELATED MEMOS/FORMS
WARNING
This Form is a guide to help design an acknowledgment of travel time pay and may not be appropriate for a particular situation without modification. Employers should consult an employment lawyer about using this Form.
To view (download) the Form, click View Form button >>Open Form
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