Employee Hours Acknowledgement

EMPLOYEE HOURS ACKNOWLEDGEMENT

Personal Information

Position Information

Start Date:

Acknowledgement of Hours and Timekeeping

I acknowledge that I am responsible for accurately recording all time worked. I will record my start time, end time and any unpaid meal breaks in the company's authorized timekeeping system each day. I understand that altering, tampering with, falsifying or permitting another person to record time on my behalf is strictly prohibited and may result in disciplinary action up to and including termination.

Timekeeping Rounding Policy: I understand that time entries may be rounded in accordance with the employer's published rounding rules. I acknowledge that rounding is not intended to result in underpayment of hours worked.

Overtime: I understand that overtime (hours worked in excess of applicable thresholds) must be pre‑approved by my manager unless otherwise provided by law. Non‑exempt employees will be paid overtime in accordance with applicable law for hours authorized and worked.

Meal and Rest Breaks: I acknowledge the company's policies regarding meal and rest breaks and will follow the requirements applicable to my position. I understand that unpaid meal breaks must be recorded when taken.

Reporting Errors: I agree to report any mistakes or discrepancies in my time records to my manager or payroll within five business days of the pay period in which the error occurred. I understand the employer will review and, if appropriate, correct errors in accordance with company policy and applicable law.

Payroll Deductions: I understand that authorized deductions and lawful deductions required by statute may be made from my pay. Any deductions for missed punches, recovered overpayments, or break violations will be made only as permitted by law and the employer's policies.

Pay Period and Hours Summary

Pay Period Start:    End:

Employment History (most recent)

Employment History (prior)

Education

References (professional)

Legal Disclosures

At‑Will Employment: I acknowledge that, unless I have a written agreement signed by an authorized company representative specifying otherwise, my employment is at‑will and may be terminated by me or the employer at any time, with or without cause or notice, subject to applicable law.

Equal Employment Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, or any other protected status under applicable law.

Authorizations and Certifications

By signing below I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I understand that falsification, misstatement, or omission of material facts may be grounds for disciplinary action, up to and including termination.

I authorize the employer to contact my previous employers and references to verify my employment history and qualifications. I further authorize the employer to conduct background checks, verify my right to work, and obtain other lawful information relevant to my employment, where permitted by law.

I acknowledge receipt of the employer's timekeeping policy and confirm that I have read and understand the procedures for recording and correcting time. I agree to comply with those procedures and to review my pay statements and time records promptly.

I acknowledge the timekeeping policy and agree to comply with its requirements.

I authorize the employer to contact previous employers and to obtain background information as described above.

Employment Classification (check one):   Exempt    Non‑Exempt

Applicant Certification

I certify under penalty of perjury that the information I have provided in this Employee Hours Acknowledgement and the accompanying records is true and accurate. I understand this form will be retained in my personnel file and used for payroll and compliance purposes.

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