Working Time Directive Opt-Out Form
This agreement is between Ray of Sunshine Care Agency, the employer, and the employee
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
The employee understands that they are entitled to have their average weekly working time limited to 48 hours per week.
Please Select
Yes
No
The employee agrees that the 48-hour limit shall not apply in their case.
Please Select
Yes
No
Question 3 (Please tick one only)
This agreement applies until it is terminated by the employee in accordance with clause 4.
3* OR This agreement applies until (insert date) or until terminated by the employee in accordance with clause 4.
Date (if second option)
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
If the employee wishes to terminate this agreement, they must be given 28 days notice in writing to the employer.
Please Select
Yes
No
This agreement is being made in accordance with Regulation 5 of the Working Time Regulations 1998.
Please Select
Yes
No
Date
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Employee Signature:
Submit
Should be Empty: