Umpire Compensation Form

Umpire Compensation Form

In Association with

---Umpire Compensation Form---

(Official Umpires Association Representatives Only)

NOTE TO UMPIRES: This form is to be filled by your designated Association Representative. If you are owed money for any reason, please contact your representative. Forms received from any one else will not be processed. Also, phone conversations between the umpire and any SDABL representative related to monies owed will not be paid until the below form has been submitted. If you have any questions pertaining to this, please contact me by email. (John Marabeas---click here).

OFFICIAL UMPIRES ASSOCIATION REPRESENTATIVE

Please fill out the form below and submit it for processing. You must provide a separate submission for each incident. Once received, the SDABL will assign an official "tracking" number, which will be emailed to you for your records. If you are unsure the amount to be compensated for a specific situation, or you are not sure which situations are in fact authorized, please click on the following link to review the SDABL "Umpire Payment Policy." (Umpire Payment Policy---click here).

COMPENSATION FORM

* = Required Information

SDABL TRACKING NUMBER (SDABL USE ONLY):

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Mailing and Endorsement Preference

1. YOUR NAME: *

2. YOUR ORGANIZATION *

3. EMAIL ADDRESS: *

4. MAILING ADDRESS

5. SHOULD CHECKS BE MAILED TO ABOVE ADDRESS? *

Yes (skip to Line 8) No (fill out Line 6)

6. IF "NO" ABOVE, INDICATE WHERE CHECKS SHOULD BE MAILED:

To the Individual Umpire's Address in Line (18) and Line (20) below

To the Name, Title, and Address of the Association Representative Listed immediately below in Line 7

7. NAME/TITLE/ADDRESS OF UMPIRE REPRESENTATIVE TO RECEIVE MAILED CHECKS

8. CHECKS SHOULD BE ENDORSED TO: *

The Individual Umpires listed in Line (17) and Line (19) below

The Name listed in Line 9 immediately below

9. ENDORSE CHECK TO THE FOLLOWING NAME:

10. OUR UMPIRES ASSOCIATION TRACKING NUMBER FOR THIS SUBMISSION (optional)

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Compensation Details

11. GAME DATE: *

12. GAME TIME *

13. GAME LOCATION: *

14. TEAM (1) INVOLVED: (list Forfeiting team here) *

15. TEAM (2) INVOLVED:

16. REASON FOR COMPENSATION (click on "Umpire Payment Policy" link above for help if needed) *

Note 1: Please provide any additional information you feel is necessary in the "Comments" box below.

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Umpires To Be Compensated

Note 2: Checks will be endorsed to the Umpire Names provided below, unless indicated otherwise in Line 8 above.

Note 3: If checks are not to be mailed to the Umpires listed below, do not provide their addresses.

Note 4: It is assumed that the category chosen in Line 16 above applies to both umpires listed below. If only one umpire requires compensation, list only that umpire's name below to alleviate confusion and/or "double payment" to the umpire who was paid out on the field.

17. UMPIRE NAME (1): *

18. UMPIRE ADDRESS (1):

19. UMPIRE NAME (2)

20. UMPIRE ADDRESS (2):

PROVIDE COMMENTS HERE