Overtime Pre-Approval Form February 2018
Per the City of Little Rock, Administrative Personnel Policy and Procedure Manual, Section II, 8 b. pg. II8.1 indicates, all
nonexempt employees are required to receive approval prior to working hours in excess of forty (40) hours in a workweek. The work
week begins at 12:00 A.M. on Saturday and ends at 11:59 P.M. on Friday.
This form is to be completed prior to working overtime when possible. In some instances, overtime may be unforeseen due to the
nature of the work, where prior approval cannot be obtained, in these cases this form should be completed as soon as possible. In cases
of mandated overtime, this form should be completed for documentation purposes.
Employee Name: Employee Number:
Job Title:
Date(s) to work requested overtime: ________________________
________AM/PM to
Date(s) to work requested overtime: ________________________
________AM/PM to
Date(s) to work requested overtime: ________________________
________AM/PM to
Number of Hours Requested: ___________
Reason for requested/mandated overtime: ______________________________________________________________________
Type of compensation agreed upon to satisfy this overtime requirement: Overtime Pay Compensatory Time
All nonexempt employees are required to maintain individual time records of hours worked on a weekly basis. Employees should
record their actual starting time (not scheduled time), time out for lunch, time in from lunch, quitting time and total hours worked for
each day. Time records should be verified and signed by the supervisor.
Employees are not permitted to begin work before the scheduled starting time or to continue working after their scheduled quitting
time (this includes taking work home and working through lunch breaks) without the prior approval of their supervisor.
City of Little Rock policy requires employees to take a lunch break of not less than thirty (30) minutes except certain public safety
Filling out another employee’s time records or falsifying anytime record is prohibited and may be grounds for action up to and
including termination of employment.
Non-exempt employees should NOT access the City’s equipment or systems during non-working hours from outside the workplace
unless they have received pre-approval (this includes checking voicemails, emails or using a city phone to make work-related calls
after hours).
APPROVAL STATUS: Approved Denied
Employee Signature Requesting Overtime Date
Supervisor/Manager Authorizing Overtime Date
Department Director Authorizing Overtime Date
Please complete and return this form to your supervisor after the overtime hours have been worked.
Tasks/Projects completed during overtime hours: Yes No Note ________________________________________
Actual overtime hours worked with dates:
Employee’s initials: Supervisor’s initials: