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Overtime Authorization Form Sample | PDF | Overtime | Employee Relations
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Overtime Authorization Form Sample

This document outlines the OSSTF overtime authorization form. Employees must submit the form to their supervisor for approval before working any overtime. The form is then returned to the employee to fill out with their name, department, project details, and estimated overtime hours. The supervisor must sign to authorize the overtime. After working the overtime, the employee fills in the actual hours, selects payment or lieu time, and signs for supervisor authorization and payment processing.

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Richard R M Thodé
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654 views1 page

Overtime Authorization Form Sample

This document outlines the OSSTF overtime authorization form. Employees must submit the form to their supervisor for approval before working any overtime. The form is then returned to the employee to fill out with their name, department, project details, and estimated overtime hours. The supervisor must sign to authorize the overtime. After working the overtime, the employee fills in the actual hours, selects payment or lieu time, and signs for supervisor authorization and payment processing.

Uploaded by

Richard R M Thodé
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OSSTF OVERTIME AUTHORIZATION FORM

Please submit the overtime form to your supervisor for approval PRIOR to working any overtime. This
form will then be returned to you to complete and sign. Once complete, this form must be: 1)
submitted to your supervisor to sign for authorization of payment/lieu time, and 2) sent to the Payroll
Department if payment is required.

Request for overtime:

_________________________________________________ _______________________________
Employee Name Department

_________________________________________________ _______________________________
Project or description of work requiring overtime Total estimated overtime hours

Approval to accrue overtime (supervisor’s approval of overtime must be obtained in advance):


I authorize this request to work overtime hours.

______________________________ ______________________________ __________________


Supervisor’s Name Supervisor's Signature Date

Actual overtime hours worked:

Week Ending I certify that this is a true and correct claim of


(Saturday's Date) overtime incurred by me on the dates listed.
Additionally, I wish to receive payment _____
Sunday or lieu time ____ for the total overtime hours
worked.
Monday
________________________________
Tuesday
Employee’s Name
Wednesday
________________________________
Thursday Employee’s Signature

Friday
________________________________
Saturday Date
Total Overtime Hours
Worked/Week
Please ensure that all hours are rounded to the nearest quarter
(e.g. 4.45 rounds to 4.50).

For Supervisor use only:


I certify that this is a true and correct claim of overtime incurred by the above employee on the above
dates. Therefore, I authorize payment/lieu time for the above overtime.

______________________________ _________________ _______________________________


Supervisor’s Signature Date Account Number (optional)

For Payroll purposes only: Confirmed by:

$_________ ___________________ $___________________ ______________


Rate of pay Total number of hours Total overtime to be paid Date to be paid

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