Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 1 of 46
No. 01-495C (Judge Bruggink)
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
KENT CHRISTOFFERSON, et al., Plaintiffs, v. THE UNITED STATES, Defendant.
EXHIBITS TO DEFENDANT'S RESPONSE TO PLAINTIFFS' BRIEF PURSUANT TO COURT'S JULY 1, 2008 ORDER AND EXHIBITS
GREGORY G. KATSAS Assistant Attorney General JEANNE E. DAVIDSON Director STEVEN J. GILLINGHAM Assistant Director Commercial Litigation Branch Civil Division Department of Justice 1100 L Street, N.W. Attn: Classification Unit, 8th Floor Washington, D.C. 20530 Attorneys for Defendant July 24, 2008
OF COUNSEL: RAYNA ELLER Office of the General Counsel Bureau of the Census Suitland, MD 20746-24
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 2 of 46
INDEX TO THE EXHIBITS Communication between Plaintiff's Attorney and Defendant's Attorney, dated March 24, 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit A Sharon West Claim Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit B Toni-Ann Jewell Claim Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit C Laura Mae Workman Claim Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit D Field Nonsupervisory Census Employee Handbook . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit E Field Supervisory Census Employee Handbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit F Carol Siemons Statement Regarding Overtime Worked . . . . . . . . . . . . . . . . . . . . . . . . . Exhibit G
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WeAt
tk
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Case 1:01-cv-00495-EGB
Document 319-2
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Page 9 of 46
CLAIM FORM
02
ZOOS
Uh
IN
Please print
clearly in
THE UNITED STATES COURT OF FEDERAL WASHINGTON DC
No
dark
ink
FUU
Name
First Middle Last
Social Security
Number
Street
Address
Apartment
Number
City
State
Zip Code
Do
you wish
to
continue
with
your claim against
the federal government
for unpaid
overtime
NO
If
Yes
please
complete
If
this
Payroll Please
Summary
No you
Claim Form and provide do not need
to
estimates
of your overtime
on the
complete
to
the rest of this Claim
at
Form
return this form and the Payroll
Summary
our offices
in this
the address
No
provided
means you no longer
wish
to
be
antJe aoE
Email Address if any
participant
lawsuit
Work
Phone Number
Best Times to
Call
Home
Phone Number
Best Times to
Call
Cell Phone
Number
Best Times to
Call
Phone Number of Relative
or Other Contacts
Optional
Please
list
any other names used while employed
by the
US
Census Bureau
in
the year
2000
CLAIM FORM
Page
of
B
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 10 of 46
10
While
working
for
the Census
Bureau
in
2000
did you
ever
work more
as
than
40 hours
in
work week Sunday
you
spent traveling
to
through Saturday You should and from your home time spent
breaks
if
include
work
time the time
activities at
on workrelated
those breaks
your
home
and lunch
or dinner
you worked
during
Yes
No
the Payroll
11
Review show
Summary produced
worked and hours
from the Census Bureau
in
payroll records
is
which
the days you
you submitted 40 hours
2000 What
per
of which
weeks
you worked
MORE THAN
many
hours
of overtime
you worked
each of those
40
40
hour
your best estimate
work week and how
weeks
should
There are spaces
indicate
on the
right
hand side of the Payroll you
believe
Summary where you
Please
in
how much
overtime
overtime hours
that
you worked
to
include
on the Payroll
decennial Operations
field
Summary
positions Supervisor
you claim
have worked
Assistant
the following Field
only
Enumerator
Field
Crew Leader
Operations
Crew Leader
Assistant
Supervisor and Special
Places
Operation
Supervisor
Example Assume
second week of
you worked Because
50 hours
in
the
first
week of May and 20
to
hours
in
the
in
May
you were not permitted
for
record
more
than
40 hours
week
you
only recorded
40 hours
the
first
week of May and
did not submit any
overtime
worked
Therefore
PAYROLL
you would indicate your estimate DATA
WED
of overtime
as
follows
ESTIMATE
PAY END
PERIOD DATE
TYPE
SUN
MON
TUE
THU
FRI
SAT
TOTAL
UNPAID OVERTIME
05062000 0506
05
2000
2000 2000 2000 2000 2000
06 05 13
REO
TRAIN
OT
TOTAL
RHO
000 000 000 000 400 000 000
800 000 000 800 800 000 000 800
800 000 000 800 800 000 000 800
800 000 000 800 000 000 000 000
800 000 000 800 000 000 000 000
800 000 000 800 000 000 000 000
000 000 000 000 000 000 000 000
4000 000 000 4000 2000 000 000 2000
0513
05
TRAIN
OT TOTAL
132000
0513
400
12
If to
you
banked rolled
Summary
to in
or carried the space hours
over any
indicated
overtime
you worked
add those also
or carried able to
the Payroll hours
Rolledover banked
in in
over
record
refer
overtime
you worked
one one
because doing so would exceed 40 hours
told to
less
week week
to
but were
not
Some
weeks
paid
census
in
employees
were
roll
or
carry
to
over
their
overtime
hours
later
which they overtime hours
worked
than 40 hours
entitled
and therefore were
recovery
already
partially
for
their
You may
be
some
even
if
you rolled over
your overtime
13
Are
of the numbers
you wrote on the Payroll
Summary based on an estimate
4Yes
CLAIM FORM
No
Page
of
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Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 11 of 46
14
If
any of your numbers where
are based
on estimates numbers
please
identify
on the Payroll
Summary
arrived
at
indicated
which
are estimates
and describe
how
you
those estimates
15
If
you have any documents
the overtime
to this
which
existed in
2000
that
may
tend
to
show
that
you of the
worked
claimed
eg
If
datebooks
calendar
entries attach
copies
documents
originals
claim
form
you provide
documents
will
send copies only
to
No
Note that
should
be provided
is
as your documents
to
not be returned
you
documentary proof
not
required
make
claim
16
Do
you believe
your supervisor knew
the overtime
or had reason
to
know
that
you worked
overtime
priopto
your working
Yes
you answered
to
No
yes to
that
17
If
Question 16 explain you worked and
overtime
is
why
you believe
your supervisor knew
the overtime
or
had reason Please
know
to
prior to your working
for
refer
pages
What
Overtime
about
examples of how your
supervisor
knew
or should
have known
your working
overtime
tEt
4o bL
If
ouet
respond
to
o5
use separate
you need additional
Clearly
space
print
to
any of the above
questions
sheet of paper
your name and
SSN
at
the top of each additional
page
and indicate the question
number
swear or affirm under penalty
the best of
of perjury
that
the above
statements
are true
to
my knowledge
and belief
Date
Print
Name
You Must Complete Sign and Return this Claim Form and the enclosed Summary by mail postmarked no later than SEPTEMBER 29 2006
If
it
Payroll
you wish
to
confirm our receipt of MailReturn
visit
this
via Registered
Receipt
local
form we strongly recommend To obtain Registered requested
office
that
you
send
MailReturn
Receipt
form
please
your
post
or go to
wwwuspscom
You must
keep
copy
of completed
forms for your records
CLAIM FORM
Page
of
B
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 12 of 46
ID
Sharon 62
7164
West SE
CUMBERLAND GATE SMYRNA GA 300807795
B
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL SUNMARY
Filed 07/24/2008
Page 13 of 46
Page of
NAME
WestSharon
LOCAL CENSUS Atlanta During
West
CHANGEDATE
OFFICE NAME
POSITION Enumerator
03272000
Hours Worked
112000
11302000
Overtime can only be claimed if you worked more than 40 hours total work week Work time includes during Sunday through Saturday travel time to and from your home time you spent at home making workrelated calls or on other work activities and time you worked lunch or dinner break during PAYROLL DATA ESTIMATE PAY PERIOD OVERTIME END DATE TYPE SUN MON TUE WED THU FRI SAT TOTAL WORICED
04012000 04012000 04012000 04012000 04082000 04082000 04082000 04082000 04292000 04292000 04292000 04292000 05062000 05062000 05062000 05062000 05132000 05132000 05132000 05132000 05202000 05202000 05202000 05202000 06032000 06032000 06032000 06032000 06102000 06102000 06102000
REG TRAIN
OT
TOTAL REG TRAIN
OT
000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
800 000 000 800 000 000 000 000 000 400 000 400 800 00 000 800 000 000 000 000 800 000 000 800 000 000 000 000
000 000 000 000 000 000 000 000 000 500 000 500 800 000 000 00 000 000 000 000 000 000 000 000 800 000 000 800
000 000 000 000 750 000 000 750 000 400 000 400 800 000 000 800 800 000 000 800 000 000 000 000 800 000 000 800
000 000 000 000 800 000 000 800 000 400 000 400 800 000 000 800 800 000 000 800 800 000 000 800 000 000 000 000 800 000 000 800
000 000 000 000
00
650 000 000 650 800 000 000 800 000 800 000 800 800 000 000 800 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
1450
000 000
1450 3150
TOTAL REG TRAIN
OT
000 000 800 000 000 000 000 000 000 000 000 800 000 000 800
00
000 000
3150
000
2500
000
2500 4000
TOTAL REG TRAIN
OT
TOTAL REG TRAIN
OT
000 000 4000
2400
TOTAL REG TRAIN
OT
000 000 2400
2400
TOTAL REG TRAIN
OT
000 000 00 000 000 000
00
000 000 2400
1600
000 000
1600 3200
TOTAL REG TRAIN
OT
10
TOTAL
000 800 000 000 000 600 000 1400
000 800 000 000 000 400 000 1200
00
00 00
000
1000
00
4200
B
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL SUMMARY
Filed 07/24/2008
Page 14 of 46
Page of
PAYROLL
PAY
DATA THU
FRI SAT
PERIOD END DATE
ESTIMATE OVERTIME TOTAL
TYPE
SUN
MON
TUE
WED
WORKED
06172000 06172000 06172000 06172000
REG TRAIN
OT
000 000
000
000
TOTAL
000
000 000 000
000 000 000 000
000 000 000 000
000 000 000 000
000 000 000 000
800 000 000 800
800 000 000 800
HOURS carried over but were worked in one week not you actually worked them and therefore
OVERTIME
ROLLEDOVER
hours refer to overtime hours that to record on the day that you later date you recorded them on Some census employees were told to roll or carry over their overtime hours to later weeks in which they worked less than 40 hours and therefore were already partially paid for their overtime
or able If If
Rolled
banked
you DID NOT
roll
over
any
overtime
hours
leave
this
section blank overtime you estimate of the
the dates on
have
rolled or carried over any of the you banked claimed above in the spaces below give your best dates those hours and also on which you actually worked hours which you recorded those on your pay form
Assume you worked 50 hours in the first week of May Because Example week you you were not permitted to record more than 40 hours in recorded only 40 for that week and then kept track of the 10 additional hours Assume you worked only 20 hours in the second week of May Instead of recording 20 hours for that week you recorded 30 the 20 actually worked that week plus the 10 carried over from the first In that Rolled week example your answer to this Question would be 10 hours from the first week of May to the second week of
May
If
you are
not
sure 20
of
exact in May
dates
to
Rolled
about
hours
June
you may estimate
For
example
la WeekDate lb
Number
of
Overtime Worked Overtime Hours
in Not
Recorded recorded
lc WeekDate 2a 2b 2c 3a 3b 3c
WeekDate
Number
of
which
Overtime was
Overtime Worked Overtime Hours
in which Not
Recorded recorded
WeekDate WeekDate
Number
of
Overtime was
Overtime Worked Overtime Hours
in Not
Recorded recorded
as
WeekDate
on the
which
Overtime was
of qive
Continue
If any of
another
numbers
sheet
paper
for
necessary RolledOver
Hours are
you
Overtime or
B
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL SUNMARY
Filed 07/24/2008
Page 15 of 46
Page of
estimates to the best of your please write out below which dates and numbers are estimates and describe how you knowledge arrived at those estimates Please use the back of the Payroll Summary sheet for your description If you need additional space use separate of paper clearly labeled with your name and SSN at the top of each additional
based on
page
op
pW
B
Case 1:01-cv-00495-EGB
Document 319-2
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Page 16 of 46
Case 1:01-cv-00495-EGB
Document 319-2
'
Filed 07/24/2008
Page 17 of 46
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Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 18 of 46
AUG
ZOOS
CLAIM FORM
IN
THE UNITED STATES COURT OF FEDERAL CLAIMS WASHINGTON DC
No
Please print clearly in dark
49
Number
ink
nn
Name
CL
Address
to
First Middle Last
Social
Security
Street
Apartment
Number
Cits7
State
Zip Code
Do
you wish
continue
with your claim against the federal government
for
unpaid
overtime
ES
NO
this
If
Yes please
complete
If
Payroll
Summary
No
Claim Form and provide
to
estimates
of your overtime
on the
you do not need
complete
to
the rest of this Claim
at
Form
Please return this form and the Payroll
No means
Summary
our offices
in this
the address
provided
you no longer
wish
to
be
participant
lawsuit
Email Address if any
Work
Phone Number
Best
Times
to
Call
Home
Phone Number
Best
Times
to
Call
Cell Phone
Number
Best Times
to
Call
Phone
mber of
Relative
or Other Contacts
Optional
Please
list
any other names used while
employed
by the
US
Census Bureau
in
the year
2000
CLAIM FORM
Page
of
C
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 19 of 46
10
While
working
for
the Census
Bureau
in
2000
did you should
ever
work more
as
than 40 hours time the time
activities at
in
work week Sunday
you
sp traveling
to
through
Saturday
You
include
work
and from your
breaks
if
home
time
spent on workrelated during those breaks
your
and lunch
or dinner
you worked
Yes
No
the Payroll
11
Review show
Summary produced
and hours
from the Census
submitted
in
Bureau
payroll records
is
which
the days
you worked you worked
you
2000 What
per
your best estimate
of which weeks
MORE THAN
40 hours
work week and how
many
hours
of overtime
you worked
each of those
40
hour
weeks
should
There are spaces
indicate
on the
right
hand side of the Payroll you believe you you worked
Summary where you
Please
in
how much
overtime
overtime hours
that
include
on the Payroll
decennial Operations
field
Summary
positions Supervisor
claim to
have worked
the following Field
only
Enumerator
Field
Crew Leader Assistant
Operations
Crew Leader
Assistant
Supervisor and Special
Places
Operation
Supervisor
Example Assume
second week of
you worked Because
50 hours
in
the
first
week
to
of
May
and 20 hours
in
the
in
May
you were not permitted
for
record
more than 40
did not
hours
week
you
only recorded
40 hours
the
first
week of May and
submit any
as
overtime
worked
Therefore
PAYROLL
you would indicate your estimate DATA
WED THU FRI SAT
of overtime
follows
ESTIMATE TOTAL
PAY END
PERIOD DATE
TYPE
SUN
MON
TUE
UNPAID OVERTIME
05062000 05062000 05062000 05062000
05
EEC TRAIN OT TOTAL
000 000 000 000 400 000 000 400
800 000 000 800 800 000 000 800
800 000 000 800 800 000 000 800
800 000 000 800 000 000 000 000
800 000 000 800 000 000 000 000
800 000 000 800 000 000 000 000
000 000 000 000 000 000 000 000
4000 000 000 4000 2000 000 000 2000
132000
13
05132000
05
2000
05132000
EEC TRAIN OT TOTAL
12
If to
you
banked rolled or
Summary
to in
carried over any overtime
indicated
you worked
add those also
or carried
to
the Payroll hours
the space hours
Rolledover banked
in in
over
record
refer
overtime
you worked
one one
because doing so would exceed 40 hours
told to
less
week week
to
but
were not able
census
in
Some
weeks
paid
employees
they
were
roll
than
or
carry
to
over
their
overtime
hours
later
which
worked
40 hours
and therefore were
recovery
already
partially
for
their
overtime hours
You may be
entitled
some
even
if
you
rolled over your overtime
13
Are
of the numbers
you
wrote on the Payroll
Summary based on an estimate
jYes
CLAIM FORM
Page
of
C
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 20 of 46
14
If
any of your numbers where
are based on estimates
please
identify on the Payroll
Summary
arrived
at
indicated
which
numbers
are estimates
and describe
how
you
those estimates
15
If
you have any documents
the overtime
to this
which
existed in
2000
that
may
tend
to
show
that
you
of the
worked
claimed
eg
If as
datebooks
calendar
entries attach
send copies
to
copies
documents
originals
claim
form
you provide
documents
will
only
No
Note that
should
be provided
is
your documents
to
not be returned
you
documentary proof
not
required
make
claim
i7V
to
16
Do
you believe
your supervisor knew
the overtime
or had reason
know
that
you worked
overtime
pri your working
Yes
No
yes to Question
that
17
If
you answered
to
16
explain overtime
is
why
you believe
to
your supervisor knew
the
or
had reason Please
know
to
you and
worked
prior
your working
for
overtime your
refer
supervisor
Vc
my knowledge
If
you need additional
sheet of paper
EE
knew
or should space
to
pages
What
Overtime
examples of
how
have known about
sEk
your working
overtime
respond
to
any of the above questions use
at
separate
Clearly
print your
name and SSN
the top of each additional
page
and indicate the question
number
swear or affirm under penalty
the best of
of perjury
that
the above
statements
are true
to
and belief
Date
Signature
Print
You Must Complete Summary by
If
it
Sign and Return
this
Claim Form and
the
enclosed Payroll
mail postmarked no later than
SEPTEMBER 29
strongly obtain
2006
you wish
to
confirm our receipt of MailReturn
visit
this
form we
recommend
Registered
that
you send
via Registered
Receipt
local
requested
post
office
To
MailReturn
Receipt
form
please
your
or go to
wwwuspscom
You mnst
keep
copy
of completed
forms for your records
CLAIM FORM
Page
of
C
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 21 of 46
ID
Toniann
Jewell
3304
LEWIS PL
YONKERS NY
107031612
C
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL SUMMARY
Filed 07/24/2008
Page 22 of 46
Page
of
NAME
llTo
LOCAL white CENSUS Plains OFFICE NAME worked During
CHANGEDATE
POSITION Enumerator
04242000
Hours
112000
11302000
Overtime can only be claimed if you worked more than 40 hours total work week work time includes during Sunday through Saturday travel time to and from your home time you spent at home making workrelated calls or on other work activities and time you worked lunch or dinner break during PAYROLL DATA ESTIMATE PAY PERIOD OVERTIME END DATE TYPE SUN MON TUE WED THU FRI SAT TOTAL WORKED
04292000 04292000 04292000 04292000 05062000 05062000 05062000 05062000 05132000 05132000 05132000 05132000 05202000 05202000 05202000 05202000 05272000 05272000 05272000 05272000 06032000 06032000 06032000 06032000 06102000 06102000 06102000 06102000 06172000 06172000 06172000 06172000
REG TRAIN
OT
TOTAL REG TRAIN
OT
000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 650 600 000 000 600 000 000 000 000 500 000 000 500
000 800 000 800 000 000 000 000 400 000 000 400 800 000 000 800 600 000 000 600 000 000 000 000 500 000 000 500 600 000 000 600
000 800 000 800 000 000 000 000 650 000 000 650 600 000 000 600 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
000 800 000 800 000 000 000 000 800 000 000 800 600 000 000 600 0Do 000 000 000 400 000 000
700 000 000 700 500 000 000 500 800 000 000 800 800 000 000 800 000 000 000 000 550 000 000 550 700 000 000 700 800 000 050 850
000 000 000 000 500 000 000 500 450 000 000 450 800 000 000 800 000 000 500 300 000 000 300 800 000 100 900 800 000 150 950
000 000 000 000
700 2400 000
3100 1400
400
000 000
000 000
1400 3900
TOTAL REG TRAIN
OT
400
800 000 000 800
000 000
3900
TOTAL REG TRAIN
OT
400
000
400
800 000 000 600 800 000 000 800 600 000 000 600 800 000 000 800
TOTAL REQ TRAIN
OT
4000 000 400 4400
50
000 000 2350 2650 000 000
2650 3250
TOTAL REG TRAIN
OT
TOTAL REG TRAIN
OT
400
650 000 000 650 000 000 000 000
000 100
3350 3500
AO
TOTAL REG TRAIN
OT
000 200
3700
TOTAL
C
Case 1:01-cv-00495-EGB
ZQ
PAY
Document 319-2
PAYROLL SUMMARY
Filed 07/24/2008
Page 23 of 46
Page
of
PAYROLL PERIOD END DATE TYPE REG TRAIN
OT
DATA THU
FRI SAT
ESTIMATE OVERTIME TOTAL
SUN
MON
TUE
WED
WORKED
06242000 06242000 06242000 06242000 07082000 07082000 07082000 07082000 07152000 07152000 07152000 07152000 07222000 07222000 07222000 07222000
TOTAL REG TRAIN
OT
500 000 000 500 000 000 000 000 000 000 000 000 000 000 000 000
000 000 000 000 000 000 000 000 800 000 000 800 600 000 000 600
000 000 000 000 000 000 000 000 600 000 000 600 000 000 000 000
000 000 000 000 000
000 000 000 000 000 000 000 000 800 000 000 800 800 000 000 800
000 000 000 000 000 800 000 800 600 000 000 600 800 000 000 800
000 000 000 000 000 000 000 000 400 000 000 400 750 000 000 750
500 000 000 500 000 800 000 800 4000 000 4000 2950 000 2950
of
000
000 000 800 000 000 800 000 000 000 000
TOTAL REG TRAIN
OT
TOTAL REG TRAIN
OT
TOTAL
HOURS carried over hours refer to overtime hours that worked in one week but were not able to record on the day that you you later date actually worked them and therefore you recorded them on
OVERTIME
ROLLEDOVER
Rolled
banked
or
census employees were told to roll or carry over their overtime hours to later weeks in which they worked less than 40 hours and therefore were already partially paid for their overtime
Some If If
you DID NOT
roll
over any overtime
hours
leave
this
section blank
rolled or carried over any of the overtime you you banked have claimed above in the spaces below give your best estimate of the dates on which you actually worked those hours and also the dates on which you recorded those hours on your pay form
Assume you worked 50 hours in the first week of May Because week you you were not permitted to record more than 40 hours in recorded only 40 for that week and then kept track of the 10 additional hours Assume you worked only 20 hours in the second week of May Instead of recording 20 hours for that week you recorded 30 the 20 that week plus the 10 carried over from the first actually worked In that example Rolled week your answer to this Question would be 10 hours from the first week of May to the second week of
Example
May
If
you
are
Rolled
not sure of exact dates you about 20 hours in May to June Overtime Worked Overtime
in
may estimate
For
example
la WeekDate lb lc
Number
of
Iloo
Hours Not
Recorded
recorded
WeekDate
which
Overtime was
C
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL
Filed 07/24/2008
Page 24 of 46
Page
of
1Q
2a WeekDate 2b
Number
of
Overtime Overtime
in
Worked
Hours Not
Recorded
recorded
2c WeekDate 3a WeekDate 3b
3c
Number
of
which
Overtime was
cr
Go
tOt
Overtime Overtime
in
Worked
Hours Not
Recorded
recorded
as
WeekDate
on
which
Overtime was
of paper
Continue
another
sheet
necessary
If any of the numbers you give for Overtime or RolledOver Hours are based on estimates write out below to the best of your please which dates and numbers are estimates and describe how you knowledge arrived at those estimates Please use the back of the Payroll Summary for your description If you need additional space use separate sheet of paper clearly labeled with your name and SSN at the top of each additional
page
On
UrE
cArd
fr
C5L4 VJt
ft
LU
Qu
C
fl
Ro
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 25 of 46
Case 1:01-cv-00495-EGB
Document 319-2
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Page 26 of 46
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 27 of 46
CLAIM FORM
Uh
IN
Please print clearly in dark
THE UNITED STATES COURT OF FEDERAL CLAIMS WASHINGTON DC THE UNITED No
LJ
49
Number
ink
tb
Social Security
Name
First Middle Last
Street
Address
Apartment
Number
City
State
Zip Code
Do
you wish
to
continue
with
your claim against the federal government
for
unpaid
overtime
NO
If
Yes please
complete
If
this
Payroll
Summary
No
Claim Form and provide
to
estimates
of your overtime
on the
you do not need
complete
to
the rest of this Claim
at
Form
Please return this form and the Payroll
Summary
our offices
in this
the address provided
No
means you no longer
wish
to
be
participant
lawsuit
LOLQM4E
Email Address if any
Work
Phone Number
Uh
Phone Number
Home
oQJiQi
Best Times
to
Best Times
to
Call
Call
Cell Phone
Number
Best
Times
to
Call
Phone Number of Relative
or Other Contacts
Optional
by the
Please
list
any other names used while
employed
US
Census
Bureau
in
the year
2000
th
CLAIM FORM
Page of
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 28 of 46
10
While
working
for
the Census through
Bureau
in
2000
did you should
ever
work more than 40
as
hours
in
work week Sunday
you
spent traveling
to
Saturday
You
include
work
time the time
activities at
and from your
breaks
if
home
time
spent on workrelated during those breaks
your
home
and lunch
or dinner
you worked
LYes
11 Review show
the Payroll the days
No
Summary produced
from the Census
submitted
in
Bureau
payroll records
is
which
you worked
and hours you
2000 What
per
of which
weeks you worked of overtime
MORE THAN
40 hours
many
hours
you worked
each of those
40
40
your best estimate
work week and how
hour
weeks
should
There are spaces
indicate
on the
right
hand
side
of the Payroll you worked
Summary where you
Please
in
how much
overtime
overtime hours
that
you believe you
include
on the Payroll
decennial Operations
field
Summary
positions Supervisor
claim to have
worked
the following Field
only
Enumerator
Field
Crew Leader
Operations
Assistant
Crew Leader
Assistant
Supervisor and Special
Places
Operation
Supervisor
Example Assume
second week of
you worked
50 hours
in
the
first
week of May and 20
to
hours
in
the
in
May
Because you were 40 hours
for
not permitted
first
record
more than 40 hours
did not
week
you
only recorded
the
week of May and
submit any
as
overtime
worked
Therefore
PAYROLL
you would indicate your estimate DATA
WED
of overtime
follows
ESTIMATE
PAY END
PERIOD DATE
TYPE
SUN
MON
TUE
THU
FRI
SAT
TOTAL
OVERTIME
05
062000
06
05062000
05
2000
RED TRAIN OT TOTAL
05062000 0513 2000 05132000 05132000 0513 2000
000 000 000 000
800 000 000 800
800 000 000 800
800 000 000 800
800 000 000 800
800 000 000 800
000 000 000 000
00
4000 000 000 4000
20 00
10
HRS
RED
TRAIN
OT TOTAL
000 000 400
000 000 800
000 000 800
000 000 000
000 000 000
000 000 000
000 000 000
000 000 2000
12
If to
you
banked rolled or
Summary
to in
carried over any overtime
indicated
you worked
add those also
or carried
to
the Payroll hours
the space hours
Rolledover banked
in in
over
record
refer
overtime
you worked
one one
because doing so would exceed 40 hours
to
week week
to
but
were not able
census
in
Some
weeks
paid
employees
were told worked
roll
or
carry
to
over
their
overtime
hours
later
which they overtime hours
less
than 40 hours
entitled
and therefore were
recovery
already
partially
for their
You may
be
some
even
if
you
rolled over
your overtime
13
Are any of the numbers
you wrote on the Payroll
Summary based on an estimate
XYes
CLAIM FORM
No
Page
of
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 29 of 46
14
If
any of your numbers where
are based on estimates
please
identify on the Payroll
Summary
indicated
which numbers
are estimates
and describe
how
you
arrived at those estimates
15
If
you have any documents
the overtime
to this
which existed
in
2000
that
may tend
to
show
that
you of the
worked
claimed
eg
If as
datebooks
calendar
entries attach
copies
documents
originals
claim
form
you provide
documents
send copies only
to
No
Note
that
should
be provided
is
your documents
to
will not be returned
you
documentary proof
not required
make
claim
16
Do
you believe
to
your supervisor knew
the overtime
or had reason
to
know
that
you worked
overtime
your working
sYes
17
If
No
Question 16 explain you worked and
overtime
is
you answered
to
yes to
that
why
you believe
your supervisor knew
the overtime
or
had reason Please
know
to
prior to your working
for
refer
pages
What
Overtime
about
examples of
how
your
supervisor
knew
or should
have known
were
not
Vv
your working
overtime
any
questions use
le
separate
If
you need additional
space
to
respond
to
any of the above
at
sheet of paper
and indicate the
Clearly print your name and SSN number question
the top
of each additional
page
swear or affirm under penalty
the best of
of perjury
that
the
above
statements
are trne
to
my
knowledge
and belief
Date
Signature
Print
Name
EQ
the
You Must Complete Summary
If
it
Sign and Return
this
Claim Form and
enclosed Payroll
by mail postmarked no later than
confirm our receipt of this form MailReturn
Receipt
SEPTEMBER 29
we
strongly obtain
2006
you wish
to
recommend
Registered
that
you
send
via Registered
requested
To
MailReturn
form please visit your local post office or go to wwwuspscom You must keep copy of completed forms for your records
Receipt
CLAIM FORM
Page
of
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 30 of 46
73
21ve
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 31 of 46
ID
Laura
7417
Workman
IL 620530273
P0 BOX 273 KAMPSVILLE
D
Case 1:01-cv-00495-EGB
SSN
Document 319-2
PAYROLL SUMMARY
Filed 07/24/2008
Page 32 of 46
Page of
NAME
WorkmanLaura LOCAL
CENSUS OFFICE
CHANGEDATE
NAME
POSITION Crew Leader
01312000
Hours
Springfield During
Worked
112000
11302000
Overtime can only be claimed if you worked more than 40 hours total work week Work time includes Sunday through Saturday travel time at home making to and from your home time you spent workrelated calls or on other work activities and time you worked lunch or dinner break during PAYROLL DATA EST IMATE PAY PERIOD OVERTIME END DATE TYPE SUN MON TUE WED THU FRI SAT TOTAL WORKED during
1Q
02052000 02 052 000 02 052 000 02052000
REG TRAIN
OT
TOTAL REG TRAIN
OT
000 000 000 000 000
00
000 800
000
800 000 000 000 000 525 000 000 525 800 000 000 800 750 000 000 750 800
000
000 800 000 800 000 000 000 000 000 000 000 000 800 000 000 800 800 000 000 800 800 000 000 800
000 800 000 800 000 000 000 000 800 000 000 800 800 000 000 800 800 000 000 800 000 000 000 000
000 800 000 800 750 000 000 750 800 000 00 00 800 000 000 800 800 000 000 800 000 000 000 000
000 800 000 800 400 000 000 400 800 000 000 800 400 000 000 400 050 000 000 050 000 000 000 000
000 000 000 000 000 000 000 000 800 000 000 800 000 000 000 000 000 000 000 000 000 000 000 000
000
4000
000
4000 1150
2620 00 02262 000 02262 000
02
02262000
TOTAL REG TRAIN
OT
000 000
00
000 000
1150 3725
03 042000
03042000 03 042 000
03042
000
TOTAL REG TRAIN
OT
000 000 000 400 000 000 400 800 000 000 800 800 000 000 800
000 000
pct
03112000 03112000
4000
000 000
TOTAL
4000
4000
03182000 03182000
REG TRAIN
OT
03182
000
000 000
4000 2400
03182000 03252000 03252000 03252000 03252000
TOTAL REG TRAIN
OT
TOTAL
000 800
000 000
2400
12V4
ROLLEDOVER
OVERTIME
HOURS
or
Ticarried
Rolled
you
banked
over
hours
worked in one week but were not able actually worked them and therefore you Some census employees were told to roll hours in which they worked to later weeks therefore were already partially paid for
If
to overtime hours that record on the day that you recorded them on later date or carry over their overtime less than 40 hours and their overtime refer to leave this
you
DID NOT
roll
over
any
overtime
hours
section
blank
D
Case 1:01-cv-00495-EGB
SSN If
Document 319-2
PAYROLL SUMMARY
Filed 07/24/2008
Page 33 of 46
Page of
rolled or carried over any of the you banked claimed above in the spaces below give your best dates those hours and also on which you actually worked which you recorded those hours on your pay form
have
overtime you estimate of the
the dates on
Assume you worked 50 hours in the first week of May Because Example in were not permitted to record more than 40 hours week you you recorded only 40 for that week and then kept track of the 10 additional hours Assume you worked only 20 hours in the second week of May Instead of recording 20 hours for that week you recorded 30 the 20 actually worked that week plus the 10 carried over from the first In that week Rolled example your answer to this Question would be 10 hours from the first week of May to the second week of
May
If
you are
not
sure 20
of
exact in May
dates
to
you
may estimate
For
example
Rolled
about
hours
la WeekDate lb
Number
of
Overtime Worked Overtime Hours Not
in
1cE
Recorded recorded
lc WeekDate 2a WeekDate 2b 2c
Number
of
which
Overtime was
Overtime Worked Overtime Hours Not
in
Recorded recorded
WeekDate WeekDate
which
Overtime was
Overtime worked Overtime Hours Not
in
3b 3c
Number
of
Recorded recorded
as
WeekDate
on
which
Overtime was
of
Continue
another
sheet
paper
necessary
If any of the numbers you give for Overtime or RolledOver Hours are based on estimates to the best of your please write out below which dates and numbers are estimates and describe how you knowledge arrived at those estimates Please use the back of the Payroll Summary for your description If you need additional space use separate sheet of paper clearly labeled with your name and SSN at the top of each additional page
044
uzrc O4TtS
DMtS
ts
rth
fnte
UjW
Mn
D
cto
pU
it
42e
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 34 of 46
'1
'
D
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 35 of 46
DEF. EX. E
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 36 of 46
E
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 37 of 46
E
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 38 of 46
E
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 39 of 46
DEF. EX. F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 40 of 46
F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 41 of 46
F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 42 of 46
F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 43 of 46
F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 44 of 46
F
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 45 of 46
DEF. EX. G
Case 1:01-cv-00495-EGB
Document 319-2
Filed 07/24/2008
Page 46 of 46
G