• All fields on this form must be completed (with the exception of ‘Co-Driver’ if no co-driver was present)
  • Please fill this form out if detention delays exceed 4 hours, as the first 4 hours are unpaid
  • Maximum pay of $150/day 
  • Requests must be sent within the week of the settlement period or they will not be paid
  • Once form is submitted, your request will be reviewed and you will be contacted
MM slash DD slash YYYY
(Please include AM or PM)
(Please include AM or PM)