(including any supporting documentation)
Your claim should include evidence of your right to work in Australia for the period of time relating to your claim,
evidence of your employment at the site/s you are making a claim against, evidence that you were underpaid, a statutory
declaration and any other supporting evidence you may have.
Where you do not have any evidence of your employment and / or evidence of your underpayment, you can still make a
claim by completing the claim form with your details. This will form part of your statutory declaration and Caltex will
consider your claim against the evidence it has to support your claim.
**Please provide a mobile phone number as we will text you a code to progress your claim
In order to calculate your claim (if eligible), we require you to populate the table below. We are not able to calculate the claim if these details are not completed. If a field is not applicable, please enter ‘0’.
Click here for an example of a correctly completed shift table.
Please include any additional comments as needed to further explain your shifts