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U. S. DEPARTMENT OF LABOR Employees Compensation Appeals Board In the Matter of ANGELO RICCARDO and U.S. POSTAL SERVICE, POST OFFICE, Summit, N.J. Docket No. 961258; Submitted on the Record; Issued

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3. Begin by entering the date in the designated field. Make sure to use the proper date format as specified in the instructions.
4. Provide your personal information, including your full name, address, phone number, and email address, in the corresponding sections of the form.
5. If applicable, fill in your job title and the name of your employer or organization in the appropriate fields.
6. Proceed to answer the questions on the form accurately and truthfully. These questions may pertain to your employment status, pay rate, hours worked, and any overtime or leave time taken.
7. Take your time to carefully read and understand each question before providing your response. Double-check your answers for accuracy and completeness.
8. Attach any supporting documents or evidence required by the form, if applicable. This could include pay stubs, timecards, or any other relevant records that support your responses.
9. Once you have completed the form, review it one final time to ensure that all information is accurate and all required fields have been filled. Make any necessary corrections or additions.
10. Sign and date the form at the bottom to certify that the information provided is true and accurate to the best of your knowledge.
11. Keep a copy of the filled-out form for your records before submitting it as required by the specific instructions provided.

Who needs 96-1258doc - dol:

1. Employees seeking to report potential violations of the Fair Labor Standards Act (FLSA).
2. Individuals making a complaint or filing a claim regarding unpaid overtime, minimum wage, or other wage-related issues.
3. Employers who are required to provide information or respond to a complaint filed by an employee or the Department of Labor regarding labor standards violations.
4. Legal professionals or representatives assisting employees or employers with labor-related disputes or claims.

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