Request/Authorization for Overtime/Compensatory Time
Overtime Pay Period:
Compensatory Time Requesting Office:
Employee Name:
Request
Approved
Total by Employee and Supervisor
Day and Date Requested Supervisor Total Actual Actual Signature
Work Performed Hours Initial/Date Hours In/Out Time (certifying Actual OT/CT worked)
Sunday
Date:
Monday
Date:
Tuesday
Date:
Wednesday
Date:
Thursday
Date:
Friday
Date:
Saturday
Date:
Justification:
Accomplishments:
Accounting Code:
Requested by: Date:
Approved by: Date:
Disapproved: Date:
Appendix A REV 10/2009