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Form Filling Instructions LOST TIME APPLICATION FOR PAYMENT IN LIEU FORM (004) PLEASE PR I N T CLEAR LY This is MOST used form. All delegates shed officials and other union members will need to fill
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How to fill out lost time application for

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How to fill out lost time application form:

01
Start by providing your personal information such as your full name, address, contact number, and email address.
02
Indicate the date on which you are filling out the form.
03
Mention the reason for your lost time and provide a detailed explanation of the circumstances that led to it.
04
Include any supporting documents or evidence that may be required, such as medical certificates or accident reports.
05
Specify the duration of the lost time, including the start and end dates.
06
If applicable, provide information about any modifications or accommodations that may be needed upon your return.
07
Sign and date the application form once you have completed all the necessary sections.

Who needs a lost time application form?

01
Employees who have experienced an injury or illness that has caused them to miss work for an extended period.
02
Individuals who have been involved in an accident or have had a personal emergency that has affected their ability to attend work.
03
Students who have faced circumstances that prevent them from attending school for a specific period, such as medical issues or family emergencies.
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The lost time application is used to report and track any time lost due to an incident or injury in the workplace.
Employees who have experienced an incident or injury resulting in lost time are required to file a lost time application.
Employees can fill out the lost time application by providing details about the incident, injury, and the time lost.
The purpose of the lost time application is to document and track any time lost due to workplace incidents or injuries for record keeping and analysis.
The lost time application must include details about the incident, injury, time lost, and any treatment received.
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