Overtime Claims Form

This form must be completed and returned to Ron/Lesley by the 7th of each month. (Forms not received on time will regrettably mean overtime can not be claimed until the following month.)

Staff Name (required)

Day 1

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 2

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 3

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 4

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 5

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 6

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Day 7

Date Overtime Worked (required)

Number of Hours Worked (required)

Reason for Overtime (required)

Signature

Please write your signature in the box below