Overtime Approval Request Form

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OVERTIME   A PPROVAL   R EQUEST   F ORM  
EMPLOYEE’S   N AME   _ ___________________  
______________________  
          ( Last)  
 
                                  (   F irst)  
EMPLOYEE’S   I D#_____________________  
EMPLOYEES’S   T ITLE________________________________________  
EMPLOYEE’S   D EPARTMENT__________________________________  
NUMBER   O F   O VERTIME   H OURS   R EQUESTED   _ ___________________  
DATE(S)   O VERTIME   W ILL   B E   U SED_____________________________  
TOTAL   D OLLAR   A MOUNT   O VERTIME   W ILL   C OST__________________  
PURPOSE/JUSTIFICATION   F OR   T HE   O VERTIME   R EQUESTED____________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
SUPERVISOR’S   S IGNATURE_________________________________________         D ATE______________  
SENIOR   L EVEL   S UPERVISOR’S   S IGNATURE_____________________________       D ATE______________  
            ( If   A pplicable)  
SVC/AD   A PPROVAL_______________________________________________         D ATE______________  
Print Form
RETURN COMPLETED FORM TO HUMAN RESOURCES
OVERTIME   A PPROVAL   R EQUEST   F ORM  
EMPLOYEE’S   N AME   _ ___________________  
______________________  
          ( Last)  
 
                                  (   F irst)  
EMPLOYEE’S   I D#_____________________  
EMPLOYEES’S   T ITLE________________________________________  
EMPLOYEE’S   D EPARTMENT__________________________________  
NUMBER   O F   O VERTIME   H OURS   R EQUESTED   _ ___________________  
DATE(S)   O VERTIME   W ILL   B E   U SED_____________________________  
TOTAL   D OLLAR   A MOUNT   O VERTIME   W ILL   C OST__________________  
PURPOSE/JUSTIFICATION   F OR   T HE   O VERTIME   R EQUESTED____________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
____________________________________________________________________________________  
SUPERVISOR’S   S IGNATURE_________________________________________         D ATE______________  
SENIOR   L EVEL   S UPERVISOR’S   S IGNATURE_____________________________       D ATE______________  
            ( If   A pplicable)  
SVC/AD   A PPROVAL_______________________________________________         D ATE______________  
Print Form
RETURN COMPLETED FORM TO HUMAN RESOURCES

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