Overtime Request Form
Employee Name
*
First Name
Last Name
Email
*
Today's Date
*
/
Month
/
Day
Year
Department
*
Has your department head approved this request?
*
Yes
No
Please have your department head approve your request before submitting to the accouting office!
Department Head
*
Department Head Email Address
*
Date(s) Overtime Will be Worked
*
Purpose of Overtime Work
*
Total allotted workweek hours
*
Requested Overage of Allotted Hours
*
Submit
Should be Empty: