Make Up Time Request Form

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Make Up Time Request Form

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Caltech Form No. PM 11-2 1/05. Make Up Time Request Form. I request the opportunity to miss ______ hours of scheduled work time on ...

Make Up Time Request Form

I request the opportunity to miss ______ hours of scheduled work time on _______________________ from ______ am/pm to ______ am/pm because of personal obligations, and to make up this missed work time during the same workweek. I would like to make up the missed work time on _____________________________ from ______ am/pm to ______ am/pm. I understand that Caltech can grant or deny my request. I also understand and agree that I will not be eligible for overtime pay for hours worked past eight and up to 11 hours on any of the days when I am making up time missed or to be missed during the same workweek, but I will receive overtime pay if I work more than 11 hours on a make up day or 40 hours in the same workweek. I have certified that I have read this request, that the information it contains is fully accurate, that Caltech has not encouraged or solicited me to take personal time off and make up the missed time, and that I am signing and submitting this request on an entirely voluntary basis.

______ DATE

____________________________________ Employee’s Name

____________________________ Employee’s Signature

____________________________________ Supervisor or Designee Name

____________________________ Supervisor or Designee Signature

Approval:

______ DATE

Caltech Form No. PM 11-2 1/05