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( d ) With respect to the unit for which the adjustment is being sought, if any adjustment has been made in the wage or salary rate of 10 percent or more of the number of employees on the pay roll actually working during any pay-roll period since January 1, 1941, or in the period immediately preceding that date, fill in the form below. Use a separate line for each adjustment. Explanations similar to the following should be used in column 3: “Merit increases,” “General increase,” “Increase to bring wages in line with those paid in other plants,” “Increases to comply with Federal ( State) minimum wage laws,” etc. D e p a r tm e n t , o c c u p a ­t io n , o r t y p e o f em ­p lo yee affected ( 1 ) D a te o f a d ju s tm e n t ( 2 ) R e a s o n f o r a d ju s tm e n t ( 3 ) A m o u n t o f a d ju s tm e n t (c e n ts p e r h o u r , o r p e rc e n t ) ( 4 ) N u m b e r o f employees d ir e c t ly a f ­fe cte d b y a d ju s tm e n t , a t t im e o f a d ju s tm e n t ( 5 ) T o t a l n u m - ? b e r o f em ­p lo yee s o n p a y r o l l in th e e n t ire u n i t a c tu ­a l l y w o r k ­i n g a t t im e o f a d ju s t ­m e n t ( 6 ) F o r a p a y - r o l l p e r io d im m e d ia te ly p re c e d in g th e d a te o f a d ju s tm e n t , f u r n is h th e f o l lo w in g in f o rm a t io n f o r th e em p lo ye es afEected b y th e a d ju s tm e n t (see In s t r u c t io n Y I ) T o t a l h o u r s w o rk e d < T ) T o t a l e a rn ­in g s a t s t r a ig h t - t im e r4 te s ( 8 ) A v e r a g e s t r a ig h t - t im e h o u r ly e a rn in g s (C o l . ( 8T —5— C o l . ( 7 ) ) C9> « DO NOT AN SWER ITEM 15 UNLESS THE PROPOSED ADJUSTMENT IS TO ELIMINATE SUBSTANDARDS OF LIV­ING OR TO ADJUST THE RATES OF SPECIFIC JOB CLASSIFICATIONS OR TO ESTABLISH JOB CLASSIFICA­TION RATES OR RATE RANGES U NDER GENERAL ORDER NO. 31. N o t e .— I f additional space is required to answer any of the items, below, continue your answers on plain sheets of paper. Be sure to number your continuations to correspond with the item and column numbers on this form. Three copies of such attachments should be submitted with this application. 15. (a ) For each existing job classification for which an adjustment is proposed or for which rates or rate ranges are proposed under General Order No. 31, enter on the form below the information indicated: Pay-roll period used: F rom _____ -_____________________________ — ________ To ______________ ;__________________________ _____ (M o n t h ) (D a y ) (Y e a r ) (M o n t h ) (D a y ) (Y e a r ) F o r a p a y -r o l l p e r io d im m e d ia te ly p re c e d in g th e d a te o f a p p lic a t io n J o b c la s s if ic a tio n ( 1 ) N u m b e r o f emplo yees in th is jo b c la s ­s if ic a t io n a c­t u a l ly 'w o r k ­in g ( 2 ) I f th e re is a n e stab lish e d ra n g e o f ra te s f o r th is jo b c la s s if ic a t io n , s ta te (see In s t r u c t io n V ) I f th e re is a n estab­lis h e d s in g le ra te ( r a t h e r th a n a r a n g e o f ra te s ) f o r th is jo b clas­s if ic a t io n , s ta te th e ra te T o t a l h o u rs w o rk e d (see In s t r u c t io n V I ) ( 8 ) T o t a l e a rn ­in g s a t s t r a ig h t -t im e ra te s (see In s t r u c t io n V I ) ( » ) A v e r a g e s t r a ig h t -t im e h o u r l y e a rn ­in g s (C o l . (9 ) M in im u m H -C o l . ( 8 ) ) d o lla rs o r ce n ts ( 3 ) M a x im u m d o lla rs o r ce n ts ( 4 ) P e r h o u r , w e e k , etc* ( 5 ) D o l la r s • o r c e n ts ( 6 ) P e r h o u r , . w e e k , e tc . ( 7 ) ( 1 0 ) (6) Do employees in the classifications listed in (a ) above now receive any payments (such as overtime, incentive, or bonus pay­ments) in addition to the straight-time rates listed in (a ) above------------------------------ .------ ------- —— Yes (U No QJ (5) (c) I f the answer to (6) is “Yes,” list on separate sheets of plain paper the methods used to determine the additional payments or bonuses. The information should be presented for each job classification or group of classifications separately where such presentation is appropriate. For example, if salaried workers involved in a proposed adjustment receive bonuses based on company earnings or if wage workers receive time and one-half their straight-time rate for'hours over 40, or if certain occu­pations receive additional incentive payments, these additions to the straight-time rates should be explained on separate attach­ments. Three copies of these attachments should be submitted with this application. ( d ) Furnish the information requested in the table below if: (1) It is proposed to make changes in any of the job classification rates or rate ranges listed in 15 (a ) above, or (2) Job classification rates or rate ranges are proposed (under General Order No. 31) for (A ) an existing plant that heretofore paid single rates for various of its job classifications and now desires to set up rate ranges for such jobs, (B ) an existing plant that heretofore had a variety of rates but no established rates or rate ranges for respective job classifications, (0 ) a new plant, or (D ) a new department of an existing plant. J o b c la s s if ic a t io n : ( I f i te m 15 (a ) a b o ve w a s f ille d o u t , b e s u re t o u se th e s am e jo b t i t le s h e r e ) ( 1 ) N u m b e r o f em ­ployees in th is jo b clas s ifica tio n w h o w i l l be d ir e c t ly affected b y th e p ro p o s a l ( 2 ) P ro p o s e d s t ra ig h t -t im e ra te s o f p a y I f a ra n g e o f ra te s is p ro p o se d f o r th is jo b classifica ­t io n , s ta te (see In s t r u c t io n V I ) I f a s in g le r a t e ( r a t h e r t h a n a ra n g e o f ra te s ) is p ro p o s e d f o r th is jo b clas s ifica tio n , s ta te th e ra te M in im u m d o lla rs o r cents ( 3 ) M a x im u m d o lla rs o r cents ( 4 ) P e r h o u r , w e e k , etc* ( 5 ) D o l la r s o r ce n ts ( 6 ) Pier h o u r , w e e k , e tc . ( 7 ) • i ~ ‘ ( e ) On separate sheets of plain paper describe the duties and responsibilities of the job classifications listed in ( d ) above, 'except that, if adjustments are proposed in more than 10 job classifications, descriptions need be furnished for only 10 key classifica-f tions: Two copies of the descriptions should be submitted with this application. (See Instruction IV.) (/) If, in addition to the rates of straight-time pay proposed in ( d ) above, bonus plans, premium payments, or other such Compen­sation are proposed which will affect the earnings of employees, give a detailed statement of such proposed changes________ .__ 16. I f approval is requested for a new plan or for the modification of an existing plan for making individual adjustments as permitted by General Order 31, describe (as requested in Instruction V I )' on separate sheets of plain paper how It is proposed to make adjustments under the prpposed plan. Three copies of the proposal should be submitted with this application. 17. State the methods used in arriving at the proposed adjustments or schedules and any other facts which will assist the Board in determining the merits- of the application____ ggi_________________________ -------------------------------------——— ----- >------- --------------- .. • ' .__________ , f See Item 4 of Exfalblt "A" ______ __________ .......1 18. Signature of applicants: This application should be signed by ( a ) both1 the employer (or.his representative) and an official of any labor organization which has been recognized or certified as the representative of any of the employees covered by this application; (5) both the employer (or his representative) and an official of the labor organization if this application is the result of an arbitration award rendered as the result of an agreement between the employer and the labor organization; ( o ) only the employer (or his representative) if the employees covered by this application are not represented by a recognized or cer­tified labor organization. ' A'1* | For the employer___ | i lL . l5 F . A f l h b y • J W B B b___ ______________ ________ V i c e . . J ? r . e s 1 d a r d i ___________________________. (N a m e o f o f fic ial) ( T i t l e } (D a t e ) Labor Organization Address - Fomke Labor Organization (N a m e o f o f fic ial) ( T i t T e ) (D a te )'