Overtime Usage Request Authorization Form



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Human Resource Services HRS Director’s Office 555 S Howes Street, Suite 204 Campus Delivery 6004 Overtime Usage Request Authorization Certification of Performance of Overtime Instructions 1.. Date: Employee Overtime Needed Date Time AM PM Maximum Manhours Needed Overtime Worked Date Time AM PM Total Overtime Hours Worked Justification Requested By Supervisor Department or Section Dept Head or Authorized Official Date Approved By This is to certify that the above requested overtime hours have been worked..

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