EFTA00036122.pdf

Type: pdf
Source set: data-set-8
Extracted text

BP-A0369 
JUN 10 
OVERTIME AUTHORIZATION 
U.S. DEPARTMENT OF JUSTICE 
FEDERAL BUREAU OF PRISONS 
To 
MCC New York 
(Institution Location) 
(Name of Employee) 
You are authorized to work overtime as follows: 
Day of Week: 
Starting: 
1500 
5 August 
2019 
Monday 
Date: 
5 August 
2019 
Approximate period: 
Purpose: project planning and administrative duties 
Reasons work cannot be accomplished during regular tours of duty: 
Shortage of administrative staff 
90 
minutes 
Warden or Authorized Supervisor 
In accordance with above authorization I certify I worked the following overtime: 
Day of Week: 
Starting: 
1500 
Monday 
and request: Overtime Pay 
Compensatory Time 
XXXXXXXXXX 
Date: 
Approximate period: 
AUX,USI 
2019 
90 
minutes 
Time verified 
(supervisor's initial) 
(To be used where not authorized 
in advance by Warden) 
(Signature of Employee) 
Approved: 
Warden 
Instructions: 
(1) Where several employees authorized, use reverse side and insert in space for "name of employee' the words 
'per names and periods on reverse side.' 
(2) "Authorized Supervisor' in accordance with written delegation of authority at institutional level per regulations. 
(3) To be prepared in Original only, processed in accordance with Institutional regulations and filed in payroll (older. 
PDF 
Prescribed by P3000 
EFTA00036122


BP-E369 (Continued) 
*When employee signs he/she should indicate "P" for Overtime Pay or "C" for Com pensatory time 
Name of Employee 
Dale 
Time 
IN 
Time 
OUT 
P' 
C' 
Signature of Employee 
Supervisor's 
ENO FORM 
PDF 
Prescribed by P3000 
EFTA00036123
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