Please fill this form out if you have any discrepancies on your paycheck. If your check is missing, please fill out the Missing Check Form. Check Discrepancy Form First Name Last Name Home Phone Cell Phone Email Employee Pin (Last 4 of Social Security Number) Assigned Facility Type of Discrepancy Missing Hours Hourly Rate Pool Party Hours Holiday Hours Other Who is your Manager/Supervisor? Pay Period of Discrepancy? Please list date, time and location (facility) of each shift worked during the pay period I certify that the above information is true and correct to the best of my knowledge. I agree reCAPTCHA If you are human, leave this field blank.