1.
1. Start Date Day/Month/Year
1. End Date Day/Month/Year
1. Regular Wages Earned During Week
2.
2. Start Date Day/Month/Year
2. End Date Day/Month/Year
2. Regular Wages Earned During Week
3.
3. Start Date Day/Month/Year
3. End Date Day/Month/Year
3. Regular Wages Earned During Week
4.
4. Start Date Day/Month/Year
4. End Date Day/Month/Year
4. Regular Wages Earned During Week
5.
5. Start Date Day/Month/Year
5. End Date Day/Month/Year
5. Regular Wages Earned During Week
6.
6. Start Date Day/Month/Year
6. End Date Day/Month/Year
6. Regular Wages Earned During Week
7.
7. Start Date Day/Month/Year
7. End Date Day/Month/Year
7. Regular Wages Earned During Week
8.
8. Start Date Day/Month/Year
8. End Date Day/Month/Year
8. Regular Wages Earned During Week
9.
9. Start Date Day/Month/Year
9. End Date Day/Month/Year
9. Regular Wages Earned During Week
10.
10. Start Date Day/Month/Year
10. End Date Day/Month/Year
10. Regular Wages Earned During Week
11.
11. Start Date Day/Month/Year
11. End Date Day/Month/Year
11. Regular Wages Earned During Week
12.
12. Start Date Day/Month/Year
12. End Date Day/Month/Year
12. Regular Wages Earned During Week
(A) Total du salaire normal gagné durant les 12 semaines précédant le licenciement
(A) Total regular wages earned during 12 weeks before termination =1. Regular Wages Earned During Week + 2. Regular Wages Earned During Week + 3. Regular Wages Earned During Week + 4. Regular Wages Earned During Week + 5. Regular Wages Earned During Week + 6. Regular Wages Earned During Week + 7. Regular Wages Earned During Week + 8. Regular Wages Earned During Week + 9. Regular Wages Earned During Week + 10. Regular Wages Earned During Week + 11. Regular Wages Earned During Week + 12. Regular Wages Earned During Week
$
(B) Salaire hebdomadaire normal ou, si vous n’en avez pas : le total du salaire normal (A) divisé par le nombre de semaines réellement travaillées au cours des 12 semaines précédant le licenciement
(B) Regular weekly wage, or if you do not have a regular weekly wage
Total regular wages (A) divided by number of weeks actually worked in the last 12 weeks before termination
$
(C) Nombre de semaines de préavis nécessaire (reportez-vous au tableau ci-dessus)
(C) Number of weeks of notice due (see chart above)
(D) Nombre de semaines de préavis (C) x salaire hebdomadaire normal (B)
(D) Number of weeks of notice (C ) × regular weekly wage (B)
(E) Plus 4 % d’indemnité de vacances [montant total (D x 0,04)]
(E) Plus 4% vacation pay (total amount (D × 0.04)
Montant total dû
Total Amount Owed = (E)
$