SALARY COMPENSATION CLAIM 

Name:

  

 

 Services Provided to the Marine Employees’ Commission for_________ 2010 

DATE

CASE

ACTIVITY/EVENT

HOURS

DAYS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Days Worked_______ Total Compensation:  ______days @ $100 per day = ______ 

_______________________________                                     _____________

Commission Member Signature                                              Dated