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On call back payments claim form


In line with PCS(AFC)2015/3 any on call session worked Monday to Friday should be no more than 16 hours; and weekends and Bank Holidays no more than 12 hours. Sessions longer than that will receive two payments.

This form is to be used in order to claim for sessions that were worked, in line with the above, but for which only one session payment was received. This is backdated to 1 October 2012.

Please attach evidence of the session (s) worked.

This form must be countersigned by your manager.

Online Form


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