Fill and Sign the Formcomp Time off Request

Compensatory Time-Off Request Form Page 1 of 2Basic form © James R. McDade (ver 02-21-01) 209-667-2300 COMPENSATORY TIME OFF (CTO) REQUEST FORM Note: Employers use this form to document the employee’s request for CTO in lieu of overtime. Note that federal law does not allow CTO; and California law has strict provisions that must be followed. Check with legal counsel if you do not know the wage and hour rules. (Delete this note prior to use.)I, __________________________________ (print name), hereby request that the overtime designated in the chart below be paid to me in the form of compensatory time off.____________________________________ __________________________Employee's Signature DateDates Overtime is to be Worked: Actual Overtime Date CTO Time Taken: Hours Worked: (To be completed by bookkeeper) _________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ___________________________________________Approval to Work Overtime:_____________________________________ __________________________Supervisor's Signature Date Attach this form to your time sheet. California Rules on use of CTO. Under California Labor Code §204.3, compensatory time off (CTO) will only be permitted if all of the following conditions are met:1.The employee must voluntarily request CTO in lieu of monetary overtime compensation, in writing, before working overtime.2.The employee must be regularly scheduled to work no less than 40 hours per week.3.The employee must not have accrued more than 240 hours of CTO.4. Time off must be granted during the employee's normal work time within a reasonable period after the employee requests the time off. In addition, the employee must be given the applicable overtime premium rate (e.g., 1 ½ hours of CTO for each hour of overtime worked).5. The CTO hours, which have accrued more than two pay periods ago, must be paid in cash at the request of the employee at the premium rate based on the employee's current rate of pay at the time the CTO hours are paid off. 6.Accrued CTO hours are paid at time of termination at the higher of the employee's final Compensatory Time-Off Request Form Page 2 of 2Basic form © James R. McDade (ver 02-21-01) 209-667-2300pay rate, or the average pay rate over the last three years. 7. The employer keeps records that accurately reflect overtime earned and taken.8.However, CTO is not available to employees subject to the following wage orders:No. 1 Manufacturing IndustryNo. 3 Canning, Freezing and Preserving IndustryNo. 5 Public Housekeeping IndustryNo. 8 Industries Handling Products After HarvestNo. 10 Amusement and Recreation IndustryNo. 13 Preparing Agricultural Products for Market on the FarmNo. 14 Agricultural Occupations