Speeding Ticket Payroll Deduction Form

Mint Mobile Detail

Speeding Ticket Payroll Deduction Acknowledgment Form

Employee Name:

Position:

Date of Incident:

Time of Ticket:

Assigned Van Number / Name:

Location of Ticket (City/Area):

Speeding Ticket Amount:

Payroll Deduction Amount:

I, _____________________, acknowledge that:

I received a speeding ticket on the date listed above while operating a Mint Mobile Detail company vehicle.
I understand that the full amount of the ticket listed above will be deducted from my next paycheck.
I understand that operating a company vehicle requires adherence to all traffic laws, and violations may result in disciplinary action in addition to financial responsibility.
I acknowledge that failure to sign this form does not exempt me from responsibility for the ticket.

Employee Signature:

Date:

Manager Signature:

Date:

Copy the text below and email it to: support@getmintmobiledetail.com

Subject: Completed Speeding Ticket Form