QUESTIONNAIRE FOR BUREAU OF PRISONS (BOP III) LAWSUITS Please type or print legibly in ink. Please complete the questionnaire fully and to the best of your ability, then sign and date it on page 38 before mailing it to Alan Banov & Associates, 1400 K Street, N.W., Suite 1000, Washington, D.C. 20005-2403. Your completed, signed questionnaire will be presented to the Government attorneys and the BOP in response to its discovery requests and possibly to the Court to support your claims. Therefore, it is imperative that you answer this completely, honestly, and legibly. I. IDENTIFYING INFORMATION FULL NAME: ____________________________________________________________________________ ANY OTHER NAMES YOU HAVE USED (SUCH AS MAIDEN NAME): __________________________ ADDRESS: ____________________________________________________________________________ ____________________________________________________________________________ PHONE NOS: (HOME)_______________________________ (WORK)______________________________ SOCIAL SECURITY NO: ____________________________________________________________________ DATE OF BIRTH: _____________________________________________________________________ E-MAIL ADDRESS: _____________________________________________________________________ II. EMPLOYMENT STATUS WITH THE BUREAU OF PRISONS (BOP) A. Date employment with the Bureau began: __________________________________ B. Are you currently employed by the Bureau? ____ Yes ____ No. Date employment with Bureau ended: _________________________ Reason: ____________________________________________________ III. EMPLOYMENT HISTORY AT BOP A. Since May 1, 1994, have you held an officially recognized collective-bargaining unit position? ______ No ______ Yes. If Yes, please list your positions since May 1, 1994, which are in a bargaining unit. (None of these positions should be listed in B below.) _______________________________________________________________________________________________ B. List every separate non-bargaining unit position you have held with the Bureau of Prisons since May 1, 1994. (Remember: you can be employed in a bargaining unit position without necessarily being a member of a union.) Start with your current or last BOP position and list in reverse chronological order all positions since May 1, 1994. If you held the same position but at different institutions, list each separately. However, do not list each step increase as a separate position. Please be sure to include all of the information requested, including the most accurate and complete dates you know or can reasonably obtain; the Bureau institution; and salary. Please DO NOT include positions which you held before May 1, 1994, or positions in a bargaining unit. They are irrelevant to this suit. POSITION START DATE END DATE GRADE/ INSTITUTION No. TITLE (Mo/Day/Yr) (Mo/Day/Yr) STEP NAME SALARY Ex. Lieutenant 11/1/97 12/6/98 GS-7/05 FCI Milan $46,000 1. _______________ ___/___/___ ___/___/___ _____/____ _________________ $___________ UNICOR POSITION? Yes ____ No ____ Did you supervise the work of other BOP employees? _____ Yes ____ No 2. _______________ ___/___/___ ___/___/___ _____/____ ________________ $__________ UNICOR POSITION? Yes ____ No ____ Did you supervise the work of other BOP employees? _____ Yes ____ No 3. _______________ ___/___/___ ___/___/___ _____/____ ________________ $__________ UNICOR POSITION? Yes ____ No ____ Did you supervise the work of other BOP employees? _____ Yes ____ No 4. _______________ ___/___/___ ___/___/___ _____/____ ________________ $__________ UNICOR POSITION? Yes ____ No ____ Did you supervise the work of other BOP employees? _____ Yes ____ No 5. _______________ ___/___/___ ___/___/___ _____/____ ________________ $__________ UNICOR POSITION? Yes ____ No ____ Did you supervise the work of other BOP employees? _____ Yes ____ No IV. SPECIFIC JOB INFORMATION BY POSITION NUMBER The following section requests detailed information about your work assignments, pre- and post-shift activities, and other specific information for each non-bargaining unit position you have held in the BOP since 5/1/94. The positions are identified by the number listed in the first (far left) column of Section III. B (above). Attached are five separate copies of this section (one for each position number listed above). (Copy pages 3-10 if you held more than 5 positions during this period.) Answer each set of questions in Part IV for each non-bargaining unit position you have held since May 1, 1994. Be sure to send us copies of any documents which directly or indirectly ordered or required you to perform the overtime work for which you claim overtime backpay. It is very important that you answer all the questions honestly, particularly those regarding the amounts of pre-shift and post-shift overtime. Remember: you will be signing this questionnaire under penalty of perjury, in accordance with federal law, and inconsistent or exaggerated answers will damage your credibility, could cause you to lose your claim, could lead the Government to discipline you, and could even subject you to criminal penalties. You have already signed your consent form under penalty of perjury. Therefore, when completing this questionnaire, consider the times you put on your consent form. SECTION IV, Part A. Job Information for Position 1: 1. Copy from III, B above (p. 2), the job title listed as Position 1:__________________________________________ All of the questions in this section refer to Position 1 and your work in Position 1. 2. Name(s) and position(s) of your immediate supervisor(s):____________________________________________ _______________________________________________________________________________________________ 3. List the posts or duty stations at which you served when you held this position and describe the duties you performed at each post or duty station: POST/DUTY STATION DESCRIPTION OF DUTIES Ex. Maintenance Department Manage employees who do all maintenance, construction, and landscaping. a.__________________________ ____________________________________________________________ ____________________________________________________________ b.__________________________ ____________________________________________________________ ____________________________________________________________ c.__________________________ ____________________________________________________________ ____________________________________________________________ 4. List the shifts you worked when you held this position and estimate the percentage of time you spent working each particular shift. The total should add up to 100% of your time. If you know the exact periods of time you worked each shift (month and year), please include actual dates, instead of estimating percentages. SHIFT (INCLUDE START AND STOP TIME) % TIME SPENT WORKING THIS SHIFT DATES ON SHIFT Ex. 8a.m. - 4p.m. 50% 6/99-8/99 ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ Total = 100% SECTION IV, Part B. Pre-Shift Activity for Position 1: 5A. When you held this position, were you required to report to a control center, or other specific location, or perform other assigned work before your work shift began? _____ YES _____ NO (If No, skip to Question 5G.) 5B. If yes, indicate work-related activities you were required to perform at your installation BEFORE YOUR SHIFT BEGAN and estimate the average time of each activity: ___ Check out equipment ------> ____ minutes per day (also complete 5D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from control center to duty station ------> ____ minutes per day ___ Other preshift activities (describe below or on p. 38 if you need more space) ___________________________________________ ------> ____ minutes per day 5C. TOTAL PRE-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 5D. How often did you check out equipment? (Check one place on each line) OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 5E. Identify each location in your institution at which you obtained each item listed in 5D, above: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5F. If the items in 5D varied according to your duty station, shift, or other condition, briefly explain: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5G. While in this position were you issued 24-hour keys? ____ NO ____ YES. If yes, state the periods of time when you were issued 24-hour keys and what the keys opened. __________________________________________________________________ __________________________________________________________________ 5H. On any occasion, did you proceed directly to your duty station without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify _________________ Please estimate the percentage of days: _____________ % of days 5I. On any occasion did your shift officially begin at the control center or at any place other than your duty post? ____ NO ____ YES [If you say YES, you will not be able to claim any traditional pre-shift overtime.] If yes, please provide the date[s] when your shift officially began at the control center or other location besides your duty post. ________________________________________________________________________ SECTION IV, Part C. Post-Shift Activity for Position 1: 6A. When you held this position, were you required to report to a control center, or other specific location other than your duty post, or perform other assigned work after your work shift ended? _____ YES _____ NO. If No, please skip to Question 6F. 6B. Indicate activities you were required to perform at your BOP installation AFTER YOUR SHIFT and estimate the average time of each activity: ___ Returning equipment ------> ____ minutes per day (also complete 6D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from duty post to control center ------> ____ minutes per day ___ Waiting for the count to clear ------> ____ minutes per day ___ Other post-shift activities (describe below or on p. 38 if you need more space) _______________________________________________ ------> ____ minutes per day 6C. TOTAL POST-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 6D. Please check the appropriate line to indicate how often you returned the equipment. OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 6E. Did you obtain and/or return different items at different times? ____No ___Yes. If yes, estimate the percentage of the days when this occurred. The items (keys, guns, etc.) are those listed in your answers to questions 5D and 6D. Ex: ____Keys, guns_____________ ___25_______ ____Control Center____ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? 6F. On any occasion, after your shift ended, did you proceed directly from your duty post out of the institution without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify ________________ 6G. At any time did your shift officially end when you dropped off equipment, etc. at the control center or other location before you left the BOP installation? Yes____ No_____ If yes, on approximately what date was your shift changed? ____________________________ (month/year) 6H. On any occasion, were you relieved from your post before the shift ended? ____ NO ____ YES If yes, please list the dates when this occurred and how long (in minutes) before the end of your shift that you were relieved. _________________________________________________________________ _________________________________________________________________ 6I. TOTAL DAILY PRE-SHIFT AND POST-SHIFT TIMES FROM 5C AND 6C ABOVE: _____ MINUTES 7. Please describe below who or what caused you to work pre-shift and post-shift overtime. Include names and position titles of any management officials who told you to perform these activities, as well as when and how they told you. (Here is an example of what we are looking for: "Warden X told me I had to be on my post-minutes before my shift began"). Were you given a document stating this? Was it general policy of the institution? Did you know of co-workers who were disciplined for not performing pre-shift work before their shift began or for not staying after their shift began for post-shift work? Were you yourself ever disciplined for such actions? Do not limit your answer to the examples provided.) Note: To remain in this case in good standing, it is imperative that you answer this question as specifically, completely, and accurately as possible. Do not leave this question blank. Attach any documents, such as post orders, that support your statements. If you need more space, continue on p. 38 or attach new pages. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION IV, Part D. Other Overtime Activities for Position 1: 8. a. Were you ordered or approved to do any other overtime work-related activities in the institution (besides traveling) while going between the control center or other location and your duty station--for example, to deliver mail, messages, or equipment? ____ No ____ Yes. Explain how you were ordered or required to do so and what you did: __________________________________________________________________________________ __________________________________________________________________________________ b. Estimate the daily time spent in this activity: ___________ minutes 9. Were you ever paid for the pre- or post-shift activities described in this section (Parts B and C above)? ____ No ____ Yes. State the period(s) for which you were paid and whether you were paid straight time, overtime, or comp. time (circle one). _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. Did you have a designated period allowed for your lunch or other meal during your work shift? ____ No [Skip Question 11 and go to Part E, on the next page] ____ Yes ---> How long were you allowed for this meal period? ____ minutes ---> Were you paid for this meal period? ____ Yes ____ No ____ Sometimes; depending on shift, duty station or other condition. Please explain: ________________________________________________________________________ ________________________________________________________________________ 11. For those occasions when you had a designated meal period during the work shift, were you allowed to leave your duty station to eat your meal? SECTION IV, Part E. Lieutenants' meetings and other meetings for Position 1: 12. At any time since May 1, 1994, have you been directed or required to attend lieutenants' meetings? ________ No (Go to question 13) ________ Yes (Please answer questions 12A, 12B, and 12C) 12A. Were you required to attend such meetings on your days off? ________ No ________ Yes If Yes, please list the dates: ____________________________________________________ If Yes, approximately how long did the meetings last? ___________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12B. Were you required to attend meetings before or after your regularly scheduled shift? __________ No __________ Yes If Yes, please provide the dates: ________________________________________________ If Yes, approximately how long did the meetings last? _____________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12C. Were you ever compensated for attending these meetings? __________ No __________ Yes, because the meetings were held during my regular shift. __________ Yes, I received compensation in the form of straight time, overtime, comp. time (circle one) during the following periods: ___________________________________________________________________ 12D. After May 1, 1994, were you directed to attend any open or "close-out" meetings before or after your scheduled shift, without being compensated for your attendance? Yes___ No____ a. If yes, please list the dates and lengths of these meetings, and identify, by name and position, who directed, assigned, or instructed you to attend them. Attach a typed list if space below is insufficient. _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ 12E. Aside from lieutenants' meetings and open or "close-out" meetings which were listed in your answers above, were you directed or assigned to attend any other meetings on your days off or before or after your shift and for which you were not paid overtime pay? If so, indicate the length of the meeting, place a check showing when it occurred, and answer (yes or no) if you were compensated for such time. Attach a typed list if the spaces below are insufficient. _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? a. Who, by name and position, directed, assigned, or instructed you to attend each meeting above? __________________________________________________________________________ b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ V. MISCELLANEOUS 13. Aside your claims in this court case, have you tried to obtain relief for these claims (such as by filing a grievance with BOP or UNICOR, a claim with the Comptroller General, or a claim in a prior BOP court case)? ________ No (Go to question 15A) ________ Yes (Please answer question 14) 14. Please identify any type of relief you have sought, the dates you tried to obtain it, explain any outcome, and provide us with any explanatory documentation if you have not already done so. _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15A. Besides yourself, are there any witnesses, friendly or not, who have first-hand knowledge or information which could support your claim for compensation for pre-shift/postshift activities? ________ No (Go to question 16) ________ Yes (Please answer question 15B) 15B. If Yes, please specify what each witness could testify to: Ex. Joe Smith, Warden ordered me to work before my shift started ___________________ ________________________________________ ___________________ ________________________________________ ___________________ ________________________________________ SECTION IV, Part B. Job Information for Position 2: 1. Copy from III, B above (p. 2), the job title listed as Position 2:__________________________________________ All of the questions in this section refer to Position 2 and your work in Position 2. 2. Name(s) and position(s) of your immediate supervisor(s):____________________________________________ _______________________________________________________________________________________________ 3. List the posts or duty stations at which you served when you held this position and describe the duties you performed at each post or duty station: POST/DUTY STATION DESCRIPTION OF DUTIES Ex. Maintenance Department Manage employees who do all maintenance, construction, and landscaping. a.__________________________ ____________________________________________________________ ____________________________________________________________ b.__________________________ ____________________________________________________________ ____________________________________________________________ c.__________________________ ____________________________________________________________ ____________________________________________________________ 4. List the shifts you worked when you held this position and estimate the percentage of time you spent working each particular shift. The total should add up to 100% of your time. If you know the exact periods of time you worked each shift (month and year), please include actual dates, instead of estimating percentages. SHIFT (INCLUDE START AND STOP TIME) % TIME SPENT WORKING THIS SHIFT DATES ON SHIFT Ex. 8a.m. - 4p.m. 50% 6/99-8/99 ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ Total = 100% SECTION IV, Part B. Pre-Shift Activity for Position 2: 5A. When you held this position, were you required to report to a control center, or other specific location, or perform other assigned work before your work shift began? _____ YES _____ NO (If No, skip to Question 5G.) 5B. If yes, indicate work-related activities you were required to perform at your installation BEFORE YOUR SHIFT BEGAN and estimate the average time of each activity: ___ Check out equipment ------> ____ minutes per day (also complete 5D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from control center to duty station ------> ____ minutes per day ___ Other preshift activities (describe below or on p. 38 if you need more space) ___________________________________________ ------> ____ minutes per day 5C. TOTAL PRE-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 5D. How often did you check out equipment? (Check one place on each line) OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 5E. Identify each location in your institution at which you obtained each item listed in 5D, above: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5F. If the items in 5D varied according to your duty station, shift, or other condition, briefly explain: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5G. While in this position were you issued 24-hour keys? ____ NO ____ YES. If yes, state the periods of time when you were issued 24-hour keys and what the keys opened. __________________________________________________________________ __________________________________________________________________ 5H. On any occasion, did you proceed directly to your duty station without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify _________________ Please estimate the percentage of days: _____________ % of days 5I. On any occasion did your shift officially begin at the control center or at any place other than your duty post? ____ NO ____ YES [If you say YES, you will not be able to claim any traditional pre-shift overtime.] If yes, please provide the date[s] when your shift officially began at the control center or other location besides your duty post. ________________________________________________________________________ SECTION IV, Part C. Post-Shift Activity for Position 2: 6A. When you held this position, were you required to report to a control center, or other specific location other than your duty post, or perform other assigned work after your work shift ended? _____ YES _____ NO. If No, please skip to Question 6F. 6B. Indicate activities you were required to perform at your BOP installation AFTER YOUR SHIFT and estimate the average time of each activity: ___ Returning equipment ------> ____ minutes per day (also complete 6D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from duty post to control center ------> ____ minutes per day ___ Waiting for the count to clear ------> ____ minutes per day ___ Other post-shift activities (describe below or on p. 38 if you need more space) _______________________________________________ ------> ____ minutes per day 6C. TOTAL POST-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 6D. Please check the appropriate line to indicate how often you returned the equipment. OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 6E. Did you obtain and/or return different items at different times? ____No ___Yes. If yes, estimate the percentage of the days when this occurred. The items (keys, guns, etc.) are those listed in your answers to questions 5D and 6D. Ex: ____Keys, guns_____________ ___25_______ ____Control Center____ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? 6F. On any occasion, after your shift ended, did you proceed directly from your duty post out of the institution without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify ________________ 6G. At any time did your shift officially end when you dropped off equipment, etc. at the control center or other location before you left the BOP installation? Yes____ No_____ If yes, on approximately what date was your shift changed? ____________________________ (month/year) 6H. On any occasion, were you relieved from your post before the shift ended? ____ NO ____ YES If yes, please list the dates when this occurred and how long (in minutes) before the end of your shift that you were relieved. _________________________________________________________________ _________________________________________________________________ 6I. TOTAL DAILY PRE-SHIFT AND POST-SHIFT TIMES FROM 5C AND 6C ABOVE: _____ MINUTES 7. Please describe below who or what caused you to work pre-shift and post-shift overtime. Include names and position titles of any management officials who told you to perform these activities, as well as when and how they told you. (Here is an example of what we are looking for: "Warden X told me I had to be on my post-minutes before my shift began"). Were you given a document stating this? Was it general policy of the institution? Did you know of co-workers who were disciplined for not performing pre-shift work before their shift began or for not staying after their shift began for post-shift work? Were you yourself ever disciplined for such actions? Do not limit your answer to the examples provided.) Note: To remain in this case in good standing, it is imperative that you answer this question as specifically, completely, and accurately as possible. Do not leave this question blank. Attach any documents, such as post orders, that support your statements. If you need more space, continue on p. 38 or attach new pages. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION IV, Part D. Other Overtime Activities for Position 2: 8. a. Were you ordered or approved to do any other overtime work-related activities in the institution (besides traveling) while going between the control center or other location and your duty station--for example, to deliver mail, messages, or equipment? ____ No ____ Yes. Explain how you were ordered or required to do so and what you did: __________________________________________________________________________________ __________________________________________________________________________________ b. Estimate the daily time spent in this activity: ___________ minutes 9. Were you ever paid for the pre- or post-shift activities described in this section (Parts B and C above)? ____ No ____ Yes. State the period(s) for which you were paid and whether you were paid straight time, overtime, or comp. time (circle one). _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. Did you have a designated period allowed for your lunch or other meal during your work shift? ____ No [Skip Question 11 and go to Part E, on the next page] ____ Yes ---> How long were you allowed for this meal period? ____ minutes ---> Were you paid for this meal period? ____ Yes ____ No ____ Sometimes; depending on shift, duty station or other condition. Please explain: ________________________________________________________________________ ________________________________________________________________________ 11. For those occasions when you had a designated meal period during the work shift, were you allowed to leave your duty station to eat your meal? SECTION IV, Part E. Lieutenants' meetings and other meetings for Position 2: 12. At any time since May 1, 1994, have you been directed or required to attend lieutenants' meetings? ________ No (Go to question 13) ________ Yes (Please answer questions 12A, 12B, and 12C) 12A. Were you required to attend such meetings on your days off? ________ No ________ Yes If Yes, please list the dates: ____________________________________________________ If Yes, approximately how long did the meetings last? ___________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12B. Were you required to attend meetings before or after your regularly scheduled shift? __________ No __________ Yes If Yes, please provide the dates: ________________________________________________ If Yes, approximately how long did the meetings last? _____________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12C. Were you ever compensated for attending these meetings? __________ No __________ Yes, because the meetings were held during my regular shift. __________ Yes, I received compensation in the form of straight time, overtime, comp. time (circle one) during the following periods: ___________________________________________________________________ 12D. After May 1, 1994, were you directed to attend any open or "close-out" meetings before or after your scheduled shift, without being compensated for your attendance? Yes___ No____ a. If yes, please list the dates and lengths of these meetings, and identify, by name and position, who directed, assigned, or instructed you to attend them. Attach a typed list if space below is insufficient. _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ 12E. Aside from lieutenants' meetings and open or "close-out" meetings which were listed in your answers above, were you directed or assigned to attend any other meetings on your days off or before or after your shift and for which you were not paid overtime pay? If so, indicate the length of the meeting, place a check showing when it occurred, and answer (yes or no) if you were compensated for such time. Attach a typed list if the spaces below are insufficient. _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? a. Who, by name and position, directed, assigned, or instructed you to attend each meeting above? __________________________________________________________________________ b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ V. MISCELLANEOUS 13. Aside your claims in this court case, have you tried to obtain relief for these claims (such as by filing a grievance with BOP or UNICOR, a claim with the Comptroller General, or a claim in a prior BOP court case)? ________ No (Go to question 15A) ________ Yes (Please answer question 14) 14. Please identify any type of relief you have sought, the dates you tried to obtain it, explain any outcome, and provide us with any explanatory documentation if you have not already done so. _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15A. Besides yourself, are there any witnesses, friendly or not, who have first-hand knowledge or information which could support your claim for compensation for pre-shift/postshift activities? ________ No (Go to question 16) ________ Yes (Please answer question 15B) 15B. If Yes, please specify what each witness could testify to: Ex. Joe Smith, Warden ordered me to work before my shift started ___________________ ________________________________________ ___________________ ________________________________________ ___________________ ________________________________________ SECTION IV, Part C. Job Information for Position 3: 1. Copy from III, B above (p. 2), the job title listed as Position 3:__________________________________________ All of the questions in this section refer to Position 1 and your work in Position 3. 2. Name(s) and position(s) of your immediate supervisor(s):____________________________________________ _______________________________________________________________________________________________ 3. List the posts or duty stations at which you served when you held this position and describe the duties you performed at each post or duty station: POST/DUTY STATION DESCRIPTION OF DUTIES Ex. Maintenance Department Manage employees who do all maintenance, construction, and landscaping. a.__________________________ ____________________________________________________________ ____________________________________________________________ b.__________________________ ____________________________________________________________ ____________________________________________________________ c.__________________________ ____________________________________________________________ ____________________________________________________________ 4. List the shifts you worked when you held this position and estimate the percentage of time you spent working each particular shift. The total should add up to 100% of your time. If you know the exact periods of time you worked each shift (month and year), please include actual dates, instead of estimating percentages. SHIFT (INCLUDE START AND STOP TIME) % TIME SPENT WORKING THIS SHIFT DATES ON SHIFT Ex. 8a.m. - 4p.m. 50% 6/99-8/99 ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ Total = 100% SECTION IV, Part B. Pre-Shift Activity for Position 3: 5A. When you held this position, were you required to report to a control center, or other specific location, or perform other assigned work before your work shift began? _____ YES _____ NO (If No, skip to Question 5G.) 5B. If yes, indicate work-related activities you were required to perform at your installation BEFORE YOUR SHIFT BEGAN and estimate the average time of each activity: ___ Check out equipment ------> ____ minutes per day (also complete 5D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from control center to duty station ------> ____ minutes per day ___ Other preshift activities (describe below or on p. 38 if you need more space) ___________________________________________ ------> ____ minutes per day 5C. TOTAL PRE-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 5D. How often did you check out equipment? (Check one place on each line) OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 5E. Identify each location in your institution at which you obtained each item listed in 5D, above: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5F. If the items in 5D varied according to your duty station, shift, or other condition, briefly explain: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5G. While in this position were you issued 24-hour keys? ____ NO ____ YES. If yes, state the periods of time when you were issued 24-hour keys and what the keys opened. __________________________________________________________________ __________________________________________________________________ 5H. On any occasion, did you proceed directly to your duty station without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify _________________ Please estimate the percentage of days: _____________ % of days 5I. On any occasion did your shift officially begin at the control center or at any place other than your duty post? ____ NO ____ YES [If you say YES, you will not be able to claim any traditional pre-shift overtime.] If yes, please provide the date[s] when your shift officially began at the control center or other location besides your duty post. ________________________________________________________________________ SECTION IV, Part C. Post-Shift Activity for Position 3: 6A. When you held this position, were you required to report to a control center, or other specific location other than your duty post, or perform other assigned work after your work shift ended? _____ YES _____ NO. If No, please skip to Question 6F. 6B. Indicate activities you were required to perform at your BOP installation AFTER YOUR SHIFT and estimate the average time of each activity: ___ Returning equipment ------> ____ minutes per day (also complete 6D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from duty post to control center ------> ____ minutes per day ___ Waiting for the count to clear ------> ____ minutes per day ___ Other post-shift activities (describe below or on p. 38 if you need more space) _______________________________________________ ------> ____ minutes per day 6C. TOTAL POST-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 6D. Please check the appropriate line to indicate how often you returned the equipment. OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 6E. Did you obtain and/or return different items at different times? ____No ___Yes. If yes, estimate the percentage of the days when this occurred. The items (keys, guns, etc.) are those listed in your answers to questions 5D and 6D. Ex: ____Keys, guns_____________ ___25_______ ____Control Center____ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? 6F. On any occasion, after your shift ended, did you proceed directly from your duty post out of the institution without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify ________________ 6G. At any time did your shift officially end when you dropped off equipment, etc. at the control center or other location before you left the BOP installation? Yes____ No_____ If yes, on approximately what date was your shift changed? ____________________________ (month/year) 6H. On any occasion, were you relieved from your post before the shift ended? ____ NO ____ YES If yes, please list the dates when this occurred and how long (in minutes) before the end of your shift that you were relieved. _________________________________________________________________ _________________________________________________________________ 6I. TOTAL DAILY PRE-SHIFT AND POST-SHIFT TIMES FROM 5C AND 6C ABOVE: _____ MINUTES 7. Please describe below who or what caused you to work pre-shift and post-shift overtime. Include names and position titles of any management officials who told you to perform these activities, as well as when and how they told you. (Here is an example of what we are looking for: "Warden X told me I had to be on my post-minutes before my shift began"). Were you given a document stating this? Was it general policy of the institution? Did you know of co-workers who were disciplined for not performing pre-shift work before their shift began or for not staying after their shift began for post-shift work? Were you yourself ever disciplined for such actions? Do not limit your answer to the examples provided.) Note: To remain in this case in good standing, it is imperative that you answer this question as specifically, completely, and accurately as possible. Do not leave this question blank. Attach any documents, such as post orders, that support your statements. If you need more space, continue on p. 38 or attach new pages. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION IV, Part D. Other Overtime Activities for Position 3: 8. a. Were you ordered or approved to do any other overtime work-related activities in the institution (besides traveling) while going between the control center or other location and your duty station--for example, to deliver mail, messages, or equipment? ____ No ____ Yes. Explain how you were ordered or required to do so and what you did: __________________________________________________________________________________ __________________________________________________________________________________ b. Estimate the daily time spent in this activity: ___________ minutes 9. Were you ever paid for the pre- or post-shift activities described in this section (Parts B and C above)? ____ No ____ Yes. State the period(s) for which you were paid and whether you were paid straight time, overtime, or comp. time (circle one). _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. Did you have a designated period allowed for your lunch or other meal during your work shift? ____ No [Skip Question 11 and go to Part E, on the next page] ____ Yes ---> How long were you allowed for this meal period? ____ minutes ---> Were you paid for this meal period? ____ Yes ____ No ____ Sometimes; depending on shift, duty station or other condition. Please explain: ________________________________________________________________________ ________________________________________________________________________ 11. For those occasions when you had a designated meal period during the work shift, were you allowed to leave your duty station to eat your meal? SECTION IV, Part E. Lieutenants' meetings and other meetings for Position 3: 12. At any time since May 1, 1994, have you been directed or required to attend lieutenants' meetings? ________ No (Go to question 13) ________ Yes (Please answer questions 12A, 12B, and 12C) 12A. Were you required to attend such meetings on your days off? ________ No ________ Yes If Yes, please list the dates: ____________________________________________________ If Yes, approximately how long did the meetings last? ___________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12B. Were you required to attend meetings before or after your regularly scheduled shift? __________ No __________ Yes If Yes, please provide the dates: ________________________________________________ If Yes, approximately how long did the meetings last? _____________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12C. Were you ever compensated for attending these meetings? __________ No __________ Yes, because the meetings were held during my regular shift. __________ Yes, I received compensation in the form of straight time, overtime, comp. time (circle one) during the following periods: ___________________________________________________________________ 12D. After May 1, 1994, were you directed to attend any open or "close-out" meetings before or after your scheduled shift, without being compensated for your attendance? Yes___ No____ a. If yes, please list the dates and lengths of these meetings, and identify, by name and position, who directed, assigned, or instructed you to attend them. Attach a typed list if space below is insufficient. _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ 12E. Aside from lieutenants' meetings and open or "close-out" meetings which were listed in your answers above, were you directed or assigned to attend any other meetings on your days off or before or after your shift and for which you were not paid overtime pay? If so, indicate the length of the meeting, place a check showing when it occurred, and answer (yes or no) if you were compensated for such time. Attach a typed list if the spaces below are insufficient. _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? a. Who, by name and position, directed, assigned, or instructed you to attend each meeting above? __________________________________________________________________________ b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ V. MISCELLANEOUS 13. Aside your claims in this court case, have you tried to obtain relief for these claims (such as by filing a grievance with BOP or UNICOR, a claim with the Comptroller General, or a claim in a prior BOP court case)? ________ No (Go to question 15A) ________ Yes (Please answer question 14) 14. Please identify any type of relief you have sought, the dates you tried to obtain it, explain any outcome, and provide us with any explanatory documentation if you have not already done so. _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15A. Besides yourself, are there any witnesses, friendly or not, who have first-hand knowledge or information which could support your claim for compensation for pre-shift/postshift activities? ________ No (Go to question 16) ________ Yes (Please answer question 15B) 15B. If Yes, please specify what each witness could testify to: Ex. Joe Smith, Warden ordered me to work before my shift started ___________________ ________________________________________ ___________________ ________________________________________ ___________________ ________________________________________ SECTION IV, Part D. Job Information for Position 4: 1. Copy from III, B above (p. 2), the job title listed as Position 4:__________________________________________ All of the questions in this section refer to Position 1 and your work in Position 4. 2. Name(s) and position(s) of your immediate supervisor(s):____________________________________________ _______________________________________________________________________________________________ 3. List the posts or duty stations at which you served when you held this position and describe the duties you performed at each post or duty station: POST/DUTY STATION DESCRIPTION OF DUTIES Ex. Maintenance Department Manage employees who do all maintenance, construction, and landscaping. a.__________________________ ____________________________________________________________ ____________________________________________________________ b.__________________________ ____________________________________________________________ ____________________________________________________________ c.__________________________ ____________________________________________________________ ____________________________________________________________ 4. List the shifts you worked when you held this position and estimate the percentage of time you spent working each particular shift. The total should add up to 100% of your time. If you know the exact periods of time you worked each shift (month and year), please include actual dates, instead of estimating percentages. SHIFT (INCLUDE START AND STOP TIME) % TIME SPENT WORKING THIS SHIFT DATES ON SHIFT Ex. 8a.m. - 4p.m. 50% 6/99-8/99 ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ Total = 100% SECTION IV, Part B. Pre-Shift Activity for Position 4: 5A. When you held this position, were you required to report to a control center, or other specific location, or perform other assigned work before your work shift began? _____ YES _____ NO (If No, skip to Question 5G.) 5B. If yes, indicate work-related activities you were required to perform at your installation BEFORE YOUR SHIFT BEGAN and estimate the average time of each activity: ___ Check out equipment ------> ____ minutes per day (also complete 5D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from control center to duty station ------> ____ minutes per day ___ Other preshift activities (describe below or on p. 38 if you need more space) ___________________________________________ ------> ____ minutes per day 5C. TOTAL PRE-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 5D. How often did you check out equipment? (Check one place on each line) OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 5E. Identify each location in your institution at which you obtained each item listed in 5D, above: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5F. If the items in 5D varied according to your duty station, shift, or other condition, briefly explain: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5G. While in this position were you issued 24-hour keys? ____ NO ____ YES. If yes, state the periods of time when you were issued 24-hour keys and what the keys opened. __________________________________________________________________ __________________________________________________________________ 5H. On any occasion, did you proceed directly to your duty station without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify _________________ Please estimate the percentage of days: _____________ % of days 5I. On any occasion did your shift officially begin at the control center or at any place other than your duty post? ____ NO ____ YES [If you say YES, you will not be able to claim any traditional pre-shift overtime.] If yes, please provide the date[s] when your shift officially began at the control center or other location besides your duty post. ________________________________________________________________________ SECTION IV, Part C. Post-Shift Activity for Position 4: 6A. When you held this position, were you required to report to a control center, or other specific location other than your duty post, or perform other assigned work after your work shift ended? _____ YES _____ NO. If No, please skip to Question 6F. 6B. Indicate activities you were required to perform at your BOP installation AFTER YOUR SHIFT and estimate the average time of each activity: ___ Returning equipment ------> ____ minutes per day (also complete 6D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from duty post to control center ------> ____ minutes per day ___ Waiting for the count to clear ------> ____ minutes per day ___ Other post-shift activities (describe below or on p. 38 if you need more space) _______________________________________________ ------> ____ minutes per day 6C. TOTAL POST-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 6D. Please check the appropriate line to indicate how often you returned the equipment. OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 6E. Did you obtain and/or return different items at different times? ____No ___Yes. If yes, estimate the percentage of the days when this occurred. The items (keys, guns, etc.) are those listed in your answers to questions 5D and 6D. Ex: ____Keys, guns_____________ ___25_______ ____Control Center____ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? 6F. On any occasion, after your shift ended, did you proceed directly from your duty post out of the institution without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify ________________ 6G. At any time did your shift officially end when you dropped off equipment, etc. at the control center or other location before you left the BOP installation? Yes____ No_____ If yes, on approximately what date was your shift changed? ____________________________ (month/year) 6H. On any occasion, were you relieved from your post before the shift ended? ____ NO ____ YES If yes, please list the dates when this occurred and how long (in minutes) before the end of your shift that you were relieved. _________________________________________________________________ _________________________________________________________________ 6I. TOTAL DAILY PRE-SHIFT AND POST-SHIFT TIMES FROM 5C AND 6C ABOVE: _____ MINUTES 7. Please describe below who or what caused you to work pre-shift and post-shift overtime. Include names and position titles of any management officials who told you to perform these activities, as well as when and how they told you. (Here is an example of what we are looking for: "Warden X told me I had to be on my post-minutes before my shift began"). Were you given a document stating this? Was it general policy of the institution? Did you know of co-workers who were disciplined for not performing pre-shift work before their shift began or for not staying after their shift began for post-shift work? Were you yourself ever disciplined for such actions? Do not limit your answer to the examples provided.) Note: To remain in this case in good standing, it is imperative that you answer this question as specifically, completely, and accurately as possible. Do not leave this question blank. Attach any documents, such as post orders, that support your statements. If you need more space, continue on p. 38 or attach new pages. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION IV, Part D. Other Overtime Activities for Position 4: 8. a. Were you ordered or approved to do any other overtime work-related activities in the institution (besides traveling) while going between the control center or other location and your duty station--for example, to deliver mail, messages, or equipment? ____ No ____ Yes. Explain how you were ordered or required to do so and what you did: __________________________________________________________________________________ __________________________________________________________________________________ b. Estimate the daily time spent in this activity: ___________ minutes 9. Were you ever paid for the pre- or post-shift activities described in this section (Parts B and C above)? ____ No ____ Yes. State the period(s) for which you were paid and whether you were paid straight time, overtime, or comp. time (circle one). _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. Did you have a designated period allowed for your lunch or other meal during your work shift? ____ No [Skip Question 11 and go to Part E, on the next page] ____ Yes ---> How long were you allowed for this meal period? ____ minutes ---> Were you paid for this meal period? ____ Yes ____ No ____ Sometimes; depending on shift, duty station or other condition. Please explain: ________________________________________________________________________ ________________________________________________________________________ 11. For those occasions when you had a designated meal period during the work shift, were you allowed to leave your duty station to eat your meal? SECTION IV, Part E. Lieutenants' meetings and other meetings for Position 4: 12. At any time since May 1, 1994, have you been directed or required to attend lieutenants' meetings? ________ No (Go to question 13) ________ Yes (Please answer questions 12A, 12B, and 12C) 12A. Were you required to attend such meetings on your days off? ________ No ________ Yes If Yes, please list the dates: ____________________________________________________ If Yes, approximately how long did the meetings last? ___________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12B. Were you required to attend meetings before or after your regularly scheduled shift? __________ No __________ Yes If Yes, please provide the dates: ________________________________________________ If Yes, approximately how long did the meetings last? _____________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12C. Were you ever compensated for attending these meetings? __________ No __________ Yes, because the meetings were held during my regular shift. __________ Yes, I received compensation in the form of straight time, overtime, comp. time (circle one) during the following periods: ___________________________________________________________________ 12D. After May 1, 1994, were you directed to attend any open or "close-out" meetings before or after your scheduled shift, without being compensated for your attendance? Yes___ No____ a. If yes, please list the dates and lengths of these meetings, and identify, by name and position, who directed, assigned, or instructed you to attend them. Attach a typed list if space below is insufficient. _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ 12E. Aside from lieutenants' meetings and open or "close-out" meetings which were listed in your answers above, were you directed or assigned to attend any other meetings on your days off or before or after your shift and for which you were not paid overtime pay? If so, indicate the length of the meeting, place a check showing when it occurred, and answer (yes or no) if you were compensated for such time. Attach a typed list if the spaces below are insufficient. _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? a. Who, by name and position, directed, assigned, or instructed you to attend each meeting above? __________________________________________________________________________ b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ V. MISCELLANEOUS 13. Aside your claims in this court case, have you tried to obtain relief for these claims (such as by filing a grievance with BOP or UNICOR, a claim with the Comptroller General, or a claim in a prior BOP court case)? ________ No (Go to question 15A) ________ Yes (Please answer question 14) 14. Please identify any type of relief you have sought, the dates you tried to obtain it, explain any outcome, and provide us with any explanatory documentation if you have not already done so. _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15A. Besides yourself, are there any witnesses, friendly or not, who have first-hand knowledge or information which could support your claim for compensation for pre-shift/postshift activities? ________ No (Go to question 16) ________ Yes (Please answer question 15B) 15B. If Yes, please specify what each witness could testify to: Ex. Joe Smith, Warden ordered me to work before my shift started ___________________ ________________________________________ ___________________ ________________________________________ ___________________ ________________________________________ SECTION IV, Part E. Job Information for Position 5: 1. Copy from III, B above (p. 2), the job title listed as Position 5:__________________________________________ All of the questions in this section refer to Position 1 and your work in Position 5. 2. Name(s) and position(s) of your immediate supervisor(s):____________________________________________ _______________________________________________________________________________________________ 3. List the posts or duty stations at which you served when you held this position and describe the duties you performed at each post or duty station: POST/DUTY STATION DESCRIPTION OF DUTIES Ex. Maintenance Department Manage employees who do all maintenance, construction, and landscaping. a.__________________________ ____________________________________________________________ ____________________________________________________________ b.__________________________ ____________________________________________________________ ____________________________________________________________ c.__________________________ ____________________________________________________________ ____________________________________________________________ 4. List the shifts you worked when you held this position and estimate the percentage of time you spent working each particular shift. The total should add up to 100% of your time. If you know the exact periods of time you worked each shift (month and year), please include actual dates, instead of estimating percentages. SHIFT (INCLUDE START AND STOP TIME) % TIME SPENT WORKING THIS SHIFT DATES ON SHIFT Ex. 8a.m. - 4p.m. 50% 6/99-8/99 ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ ____________________________________ -------------> __________________% _________________ Total = 100% SECTION IV, Part B. Pre-Shift Activity for Position 5: 5A. When you held this position, were you required to report to a control center, or other specific location, or perform other assigned work before your work shift began? _____ YES _____ NO (If No, skip to Question 5G.) 5B. If yes, indicate work-related activities you were required to perform at your installation BEFORE YOUR SHIFT BEGAN and estimate the average time of each activity: ___ Check out equipment ------> ____ minutes per day (also complete 5D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from control center to duty station ------> ____ minutes per day ___ Other preshift activities (describe below or on p. 38 if you need more space) ___________________________________________ ------> ____ minutes per day 5C. TOTAL PRE-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 5D. How often did you check out equipment? (Check one place on each line) OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 5E. Identify each location in your institution at which you obtained each item listed in 5D, above: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5F. If the items in 5D varied according to your duty station, shift, or other condition, briefly explain: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5G. While in this position were you issued 24-hour keys? ____ NO ____ YES. If yes, state the periods of time when you were issued 24-hour keys and what the keys opened. __________________________________________________________________ __________________________________________________________________ 5H. On any occasion, did you proceed directly to your duty station without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify _________________ Please estimate the percentage of days: _____________ % of days 5I. On any occasion did your shift officially begin at the control center or at any place other than your duty post? ____ NO ____ YES [If you say YES, you will not be able to claim any traditional pre-shift overtime.] If yes, please provide the date[s] when your shift officially began at the control center or other location besides your duty post. ________________________________________________________________________ SECTION IV, Part C. Post-Shift Activity for Position 5: 6A. When you held this position, were you required to report to a control center, or other specific location other than your duty post, or perform other assigned work after your work shift ended? _____ YES _____ NO. If No, please skip to Question 6F. 6B. Indicate activities you were required to perform at your BOP installation AFTER YOUR SHIFT and estimate the average time of each activity: ___ Returning equipment ------> ____ minutes per day (also complete 6D) ___ Roll call ------> ____ minutes per day ___ Briefing, instructions ------> ____ minutes per day ___ Travel time from duty post to control center ------> ____ minutes per day ___ Waiting for the count to clear ------> ____ minutes per day ___ Other post-shift activities (describe below or on p. 38 if you need more space) _______________________________________________ ------> ____ minutes per day 6C. TOTAL POST-SHIFT TIME FOR ACTIVITIES LISTED ABOVE ____ minutes per day 6D. Please check the appropriate line to indicate how often you returned the equipment. OTHER ONCE A ONCE A ONCE A (PLEASE EQUIPMENT EVERY DAY WEEK MONTH YEAR SPECIFY) KEYS _____________ ___________ ___________ ___________ _____________ GUN(S) _____________ ___________ ___________ ___________ _____________ TOOLS _____________ ___________ ___________ ___________ _____________ RADIO _____________ ___________ ___________ ___________ _____________ DETAIL POUCHES _____________ ___________ ___________ ___________ _____________ BODY ALARM _____________ ___________ ___________ ___________ _____________ MAIL BAGS _____________ ___________ ___________ ___________ _____________ OTHER (SPECIFY) _____________ ___________ ___________ ___________ _____________ 6E. Did you obtain and/or return different items at different times? ____No ___Yes. If yes, estimate the percentage of the days when this occurred. The items (keys, guns, etc.) are those listed in your answers to questions 5D and 6D. Ex: ____Keys, guns_____________ ___25_______ ____Control Center____ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? __________________________ _____________ ____________________ Item(s) obtained and/or returned % of days Where obtained? 6F. On any occasion, after your shift ended, did you proceed directly from your duty post out of the institution without reporting to a control center or other specific location? ____ NO ____ YES If Yes, about how often did this happen? ____ Once a week ____ Once a month ____ Twice a month ____ Once a year ____ Other; please specify ________________ 6G. At any time did your shift officially end when you dropped off equipment, etc. at the control center or other location before you left the BOP installation? Yes____ No_____ If yes, on approximately what date was your shift changed? ____________________________ (month/year) 6H. On any occasion, were you relieved from your post before the shift ended? ____ NO ____ YES If yes, please list the dates when this occurred and how long (in minutes) before the end of your shift that you were relieved. _________________________________________________________________ _________________________________________________________________ 6I. TOTAL DAILY PRE-SHIFT AND POST-SHIFT TIMES FROM 5C AND 6C ABOVE: _____ MINUTES 7. Please describe below who or what caused you to work pre-shift and post-shift overtime. Include names and position titles of any management officials who told you to perform these activities, as well as when and how they told you. (Here is an example of what we are looking for: "Warden X told me I had to be on my post-minutes before my shift began"). Were you given a document stating this? Was it general policy of the institution? Did you know of co-workers who were disciplined for not performing pre-shift work before their shift began or for not staying after their shift began for post-shift work? Were you yourself ever disciplined for such actions? Do not limit your answer to the examples provided.) Note: To remain in this case in good standing, it is imperative that you answer this question as specifically, completely, and accurately as possible. Do not leave this question blank. Attach any documents, such as post orders, that support your statements. If you need more space, continue on p. 38 or attach new pages. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ SECTION IV, Part D. Other Overtime Activities for Position 5: 8. a. Were you ordered or approved to do any other overtime work-related activities in the institution (besides traveling) while going between the control center or other location and your duty station--for example, to deliver mail, messages, or equipment? ____ No ____ Yes. Explain how you were ordered or required to do so and what you did: __________________________________________________________________________________ __________________________________________________________________________________ b. Estimate the daily time spent in this activity: ___________ minutes 9. Were you ever paid for the pre- or post-shift activities described in this section (Parts B and C above)? ____ No ____ Yes. State the period(s) for which you were paid and whether you were paid straight time, overtime, or comp. time (circle one). _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. Did you have a designated period allowed for your lunch or other meal during your work shift? ____ No [Skip Question 11 and go to Part E, on the next page] ____ Yes ---> How long were you allowed for this meal period? ____ minutes ---> Were you paid for this meal period? ____ Yes ____ No ____ Sometimes; depending on shift, duty station or other condition. Please explain: ________________________________________________________________________ ________________________________________________________________________ 11. For those occasions when you had a designated meal period during the work shift, were you allowed to leave your duty station to eat your meal? SECTION IV, Part E. Lieutenants' meetings and other meetings for Position 5: 12. At any time since May 1, 1994, have you been directed or required to attend lieutenants' meetings? ________ No (Go to question 13) ________ Yes (Please answer questions 12A, 12B, and 12C) 12A. Were you required to attend such meetings on your days off? ________ No ________ Yes If Yes, please list the dates: ____________________________________________________ If Yes, approximately how long did the meetings last? ___________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12B. Were you required to attend meetings before or after your regularly scheduled shift? __________ No __________ Yes If Yes, please provide the dates: ________________________________________________ If Yes, approximately how long did the meetings last? _____________ minutes If Yes, who directed you to attend these meetings? ______________________________ 12C. Were you ever compensated for attending these meetings? __________ No __________ Yes, because the meetings were held during my regular shift. __________ Yes, I received compensation in the form of straight time, overtime, comp. time (circle one) during the following periods: ___________________________________________________________________ 12D. After May 1, 1994, were you directed to attend any open or "close-out" meetings before or after your scheduled shift, without being compensated for your attendance? Yes___ No____ a. If yes, please list the dates and lengths of these meetings, and identify, by name and position, who directed, assigned, or instructed you to attend them. Attach a typed list if space below is insufficient. _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend _______________ _______________ __________________________________________________ Date of Meeting Length of Meeting Supervisor who directed, assigned, or instructed you to attend b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ 12E. Aside from lieutenants' meetings and open or "close-out" meetings which were listed in your answers above, were you directed or assigned to attend any other meetings on your days off or before or after your shift and for which you were not paid overtime pay? If so, indicate the length of the meeting, place a check showing when it occurred, and answer (yes or no) if you were compensated for such time. Attach a typed list if the spaces below are insufficient. _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? _____________ _______________ _______ _________ _________ _____________ Date of meeting Length of Meeting Days off Pre-Shift Post-Shift Compensated? a. Who, by name and position, directed, assigned, or instructed you to attend each meeting above? __________________________________________________________________________ b. Was the direction to attend these meetings in writing? Yes___ No____ If you have them, please attach copies of any written directions, assignments or instructions. Document(s) are attached: Yes_____ No_____ V. MISCELLANEOUS 13. Aside your claims in this court case, have you tried to obtain relief for these claims (such as by filing a grievance with BOP or UNICOR, a claim with the Comptroller General, or a claim in a prior BOP court case)? ________ No (Go to question 15A) ________ Yes (Please answer question 14) 14. Please identify any type of relief you have sought, the dates you tried to obtain it, explain any outcome, and provide us with any explanatory documentation if you have not already done so. _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15A. Besides yourself, are there any witnesses, friendly or not, who have first-hand knowledge or information which could support your claim for compensation for pre-shift/postshift activities? ________ No (Go to question 16) ________ Yes (Please answer question 15B) 15B. If Yes, please specify what each witness could testify to: Ex. Joe Smith, Warden ordered me to work before my shift started ___________________ ________________________________________ ___________________ ________________________________________ ___________________ ________________________________________ Please send us copies of all documents which support your claims or are in any way relevant to this case. Please check which documents you are enclosing: _________ Post orders or other documents requiring you to do pre-shift/post-shift work. _________ Pay stubs, earnings/leave statements, and other salary documents _________ Communications or other notifications of any personnel actions, such as promotions _________ Any records made of time spent in pre-shift or post-shift activities _________ Any records made of time spent in lieutenants' meetings _________ No documents are enclosed ADDITIONAL NOTES AND COMMENTS Use the space below, if you need it, to complete your answers or to make additional comments relevant to the pay issues in your claims. Also, describe any harassment or reprisal that you believe you have experienced as a result of joining this lawsuit--for example, any coercive interrogation by BOP or UNICOR officials or adverse personnel actions against you after you presented your claim. (Do not write anything here which you intend to be, or which should be, kept confidential between you and your attorney. Your completed questionnaire will be given to the Government and perhaps the Court.) VI. VERIFICATION STATEMENT In accordance with 29 U.S.C. §1746, I declare under penalty of perjury that the answers in this questionnaire are true and correct to the best of my knowledge, information, and belief. I understand that my questionnaire will be presented to the Government's attorneys in my court case and may be presented to the Court. Date: ___________________ Signature: ________________________________ _________________________________ Name printed or typed After signing and dating this questionnaire, make a copy for yourself. Then mail the signed, completed questionnaire, along with any supporting pay records or other documentation, to: Alan Banov, Esq. Alan Banov and Associates, P.C. 1400 K Street, N.W., Suite 1000 Washington, D.C. 20005-2403 Please do not fax this questionnaire, as we need the signed, original only. Questions may be addressed to Alan Banov or Norberto Salinas at alanbanov@aol.com, or 202-842-9332. 2 BPQ3