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Employee Cash Advance Form

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Name: Street Address: City: CASH ADVANCE AGREEMENT WORK ASSIGNMENT: In consideration for providing a cash advance for you to mobilize to the work assignment location at you agree to the following terms and/or conditions of this cash advance agreement the sole purpose of which is to fully reimburse the total of the cash advance amount. agrees to advance you the sum of $ ($for the purpose of: ) to be used by you to offset the initial cost(s) of mobilizing to the work assignment location area and, in consideration for this advance, you agree to reimburse portions of the advance upon each date listed in the following “Cash-advance Reimbursement Schedule” until the balance of the advance is repaid to , or in full one week from the date of receipt of this cash advance: CASH-ADVANCE REIMBURSEMENT SCHEDULE 1st payment 2nd payment 3 payment rd amount: $ amount: $ amount: $ Due date (WE): Due date (WE): Due date (WE): Further, you agree that each reimbursement payment will be made by payroll deduction. By signing this agreement you indicate your complete acceptance of terms of this agreement as well as to indicate that you are obligating yourself to the sum of the dollars referenced herein until such time as they are fully reimbursed to , knowing fully that this agreement is strictly a binding agreement for the advancement of funds and in no way will be construed by you as an employment agreement. Finally, by signing this agreement you authorize to deduct any amounts owed to from any funds that may be due you upon early termination, or otherwise eventual conclusion, of the referenced work assignment. Agreed and accepted: _________________________________________ Name ______________ Date ______________ Drivers license no. ______________________________________________________ Precision Resource Company __________________ Date CASH ADVANCE REQUEST NAME: EMPLOYEE: DATE : AMOUNT: NEEDED BY: ACCOUNT #: REASON FOR ADVANCE: Will be picked up from accounting Send directly to employee Return to via inter-office mail AUTHORIZATION Authorization can be provided by the following: Fax to
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