YOUR LOGO	REQUEST FOR OVERTIME AUTHORIZATION FORM
DEPARTMENT INFO
DEPARTMENT HEAD	DEPARTMENT	CONTACT NUMBER
OVERTIME REQUEST INFO
OVERTIME START DATE	OVERTIME END DATE	OVERTIME HOURS	ESTIMATED OVERTIME PAY
00/00/00	00/00/00	0.00	$0.00
PURPOSE / REASON FOR OVERTIME: Please provide detailed explanation.
Complete either EMPLOYEE-SPECIFIC or DEPARTMENT-SPECIFIC section per form request.
EMPLOYEE INFO
EMPLOYEE NAME	EMPLOYEE ID	JOB CODE	CONTACT NUMBER
DEPARTMENTAL REQUEST
DEPARTMENTAL OVERTIME REQUEST (multi-employee) JOB CODES List all Department Job Codes for requested Overtime.
ACCOUNT INFO
UNIT NUMBER	ACCOUNT NAME	ACCOUNT NUMBER
Submit completed request form to:
NAME	TITLE	DATE SUBMITTED
FORM COMPLETED BY	00/00/00
APPROVAL
TITLE	NAME	SIGNATURE	DATE
Supervisor / Primary Investigator	00/00/00
Director / Chair	00/00/00
Assoc VP / Dean	00/00/00
FINAL APPROVAL: Vice President or Des. Auth.	00/00/00
ADDITIONAL COMMENTS / INSTRUCTIONS

UNIVERSITY OVERTIME REQUEST FORM

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