| REQUEST TO EARN OVERTIME/COMPENSATORY-TIME LEAVE |
ACTUAL OVERTIME/COMPENSATORY TIME HOURS EARNED |
| Dates Requested | Hours Requested | Budget Code:
Fund Org Acct/Site |
Initials of Budget Code Dept. Head (if applicable)* |
Description of Work |
Dates
Worked |
Hours Worked
From To |
Total
Hours |
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| *The initials of the Budget Code’s Department Head are required if charged to a budget code other than the employee’s department. The employee’s FLSA Classification is: ______NON-EXEMPT _______ EXEMPT I approve the employee listed above to work the days and times listed and request the following form of compensation for hours earned. ____________ Overtime Pay* __________ Compensatory Time Leave Immediate Supervisor/Department Head ____________________________ date __________ Intermediate Supervisor/Department Head __________________________ date __________ (if applicable) Availability of Funds ___________________________________________ date __________ for Overtime Pay*: Assistant Vice Chancellor, Financial Services |
I certify that I have worked the above listed hours.
Employee’s Signature_______________________________ date _______ I hereby certify that the employee has worked the above listed hours and is eligible for Overtime Pay/Compensatory Time compensation as determined by the College’s Appointing Authority in accordance with FLSA regulations and State of Louisiana Civil Service Rules. Immediate Supervisor/Department Head _________________ date _______ Intermediate Supervisor/Department Head ______________ date _______ (if applicable) |