(FORM "C")
Employee Name Employee Number Cost Center
As of our records indicate you have received an overpayment in the amount of
(Today’s Date)
$ , and/or _______________ vacation hours
(Current amount) (Current amount)
The overpayment occurred for the following reason(s):
DUE TO THE SENSITIVE NATURE OF THIS SUBJECT, I AGREE THAT I WILL KEEP THIS INFORMATION CONFIDENTIAL. To allow recovery on this overpayment, I hereby select and agree to the repayment option indicated below:
A. Employee agrees to a repayment schedule deduction in the amount of $_________ per check for ____ successive checks. This agreed-upon amount is based on individual circumstances, and is established in accordance with the Payroll Overpayment Policy and applicable law.
B. Employee agrees to apply an equal value amount of his/her remaining 2006 earned vacation to the overpayment balance (in other words, the employee agrees not to take these vacation hrs in 2006).
C. Employee elects to reimburse the entire overpayment balance in one lump sum. Employees who select this option may tender reimbursement by check or money order for the full amount of the outstanding balance, made payable to: American Eagle Airlines, Inc. Employee number should be written on the check. Payments should be mailed to:
American Eagle Airlines Payroll Customer Service 7645 E. 63rd St MD 790
Tulsa, OK 74133
Employee must select one of the foregoing options on or before_________________.
Upon completion of all steps in any of the selected options, the employee will be credited by American Eagle Airlines with payment in full of the total owed amount specified above.
*Please note: Failure to make an election prior to the above deadline will be deemed a rejection of each and every method of repayment proposed above. In that situation, Company practice currently dictates that we begin recovering the entire overpayment balance in full.
(Employee Signature) (Date Signed)
(Eagle Management Representative Signature)