Can this be executed electronically?

Yes. Electronic signatures meeting ESIGN Act criteria establish intent and enforceability for most transactions; ensure consent and retention in line with 15 U.S.C. ch. 96 and applicable state UETA rules.

When is a per diem taxable?

Per diem amounts are taxable if not substantiated with receipts or if they exceed federal per diem safe harbors; consult IRS substantiation rules and your payroll tax advisor.

Do approvals need notarization or witnesses?

Not typically for internal HR per diem exceptions; notarization or witnesses may be required only if state law or a specific employer policy demands it.

How long must we retain the agreement?

Retain for at least 3 years for IRS purposes (IRC §6501(a)); if PHI is included, follow HIPAA six-year retention (45 CFR §164.530(j)). State laws may require longer.

What authentication is sufficient for signatures?

Email-based authentication is often adequate; higher-risk scenarios may require SMS, KBA, or multi-factor methods consistent with internal policy and regulatory expectations.

What if payroll treats the payment incorrectly?

Notify HR and payroll immediately to correct withholding or reporting; document corrections and retain amended records for audit trails and potential IRS inquiries.

Electronic Signature
Templates
HR
HR Per Diem Exception Agreement

HR Per Diem Exception Agreement

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HR Per Diem Exception Agreement

Document Analysis

This Per Diem Exception Agreement is an HR administrative contract between the Employer and an Employee to authorize temporary or permanent deviation from the standard per diem policy. A real-world version includes: identification of parties and employee information; recitals describing policy references; specific exception terms (rates, dates, limits); justification and required approvals; documentation and reimbursement procedures; tax and withholding treatment; conditions for revocation or repayment; and signatures of both Employee and Employer-authorized representative. The agreement contains substantive certification and authorization language permitting verification of employment history and supporting documentation. This document is intended to be signed by both the employee and the employer representative.

Employee Information

Full Legal Name Home Address

Phone

Email

Position & Employment Details

Job Title Department Reporting Manager

Effective Date of Exception: Anticipated End Date:

Per Diem Exception Details

Standard per diem policy reference: .

Authorized Per Diem Rate

Exception applies to: Travel days Field assignment Remote temporary assignment

Maximum Daily Reimbursement (if different) Documentation Required

Justification & Approvals

Business Justification for Exception Approving Manager Name

Manager Approval: Approved Denied

Duration, Reimbursement & Tax Treatment

Reimbursement Method (select one): Expense report Payroll adjustment Other:

Tax Treatment Notes (if any)

Conditions, Repayment & Revocation

Conditions of Exception (examples)

Employee agrees that any overpayment or unauthorized per diem paid under this exception is repayable to Employer: Yes No

Employment History (Most Recent)

Employer 1 - Company Name Title / Position

Dates Employed: From To

Primary Responsibilities Reason for Leaving

Employment History (Prior)

Employer 2 - Company Name Title / Position

Dates Employed: From To

Primary Responsibilities Reason for Leaving

Education

Degree Institution

Graduation Date:

References (Professional)

Reference 1 - Name Phone Email Relationship Reference 2 - Name Phone Email Relationship Reference 3 - Name Phone Email Relationship

Legal Disclosures

At-Will Employment: Employee acknowledges that this per diem exception does not alter the at-will nature of employment. Either Employer or Employee may terminate employment at any time, with or without cause or notice, unless otherwise provided in a signed written agreement.

Equal Opportunity Statement: Employer provides equal employment opportunities and will not discriminate on the basis of protected characteristics. The granting of this exception is discretionary and will be applied consistently with applicable nondiscrimination policies.

Applicant Certification & Authorizations

I certify that all information contained in this agreement and any supporting documents is true and complete to the best of my knowledge. I authorize the Employer to verify my employment history and to conduct any required background checks necessary to confirm eligibility for the per diem exception.

I certify the above statements

I authorize contact with prior employers and third-party verifiers

Acknowledgment of Policy Compliance

Employee acknowledges receipt of any related travel or per diem policy and agrees to comply with documentation and approval procedures. Employee understands that lack of adequate receipts or falsified claims may result in denial of reimbursement, disciplinary action, or requirement to repay amounts paid under this exception.

Employee Printed Name:

By:

Date:

Employer Representative Printed Name:

By (Title):

Date:

What the HR Per Diem Exception Agreement Is

An HR Per Diem Exception Agreement documents an approved deviation from an employer's standard per diem policy for meals, lodging, or incidental expenses during travel. The form records the employee, dates covered, the exception reason, the adjusted per diem rate or reimbursement method, and required approvals. It creates an auditable record for payroll, benefits, and tax compliance, and helps payroll reconcile reimbursements with withholding and reporting rules. Use it when a standard per diem rate is inappropriate due to special circumstances or business necessity.

Why Having a Clear Exception Agreement Matters

A written HR Per Diem Exception Agreement reduces errors, documents managerial approval, and provides evidence for payroll and tax treatments. It protects employees and employers by clarifying entitlement, timing, and any taxable components.

Who Typically Completes or Signs This Agreement

HR, payroll, and the employee work together to complete the HR Per Diem Exception Agreement; a manager or director generally signs to approve the exception.

Human Resources professionals who ensure policy consistency and retention for audit purposes.
Payroll staff who need the details to process reimbursements and tax withholding correctly.
Supervisors or budget owners who authorize exceptions for operational needs or unusual travel.

Maintain a copy in the employee record and share the final signed agreement with payroll and the employee to ensure consistent processing.

Primary Signatories and Their Roles

HR Manager

Manages policy enforcement, verifies that the exception aligns with company rules, records approvals in personnel files, and advises payroll on tax treatment and retention requirements.

Approving Manager

Requests and documents the business reason for the exception, confirms budget availability, and certifies that the exception is necessary and limited to specified dates and amounts.

Key Elements to Include in a Professional Agreement

A complete HR Per Diem Exception Agreement clearly assigns responsibility, dates, amounts, and tax treatment so payroll and auditors can reconcile reimbursements without ambiguity.

Employee Details

Full legal name, employee ID, department, and contact information so payroll can match the agreement to the correct personnel record and pay cycle.

Travel Period

Exact start and end dates and times for which the exception applies, including time zones if travel crosses them, so per diem allocation is precise.

Exception Type

Specify whether the exception changes meal per diem, lodging, incidental allowances, or uses an actual expense reimbursement method instead of a flat per diem.

Adjusted Amount

State the approved per diem rate or maximum reimbursable amount and whether partial days are prorated; note currency for international travel.

Tax Treatment

Document whether amounts are taxable, non-taxable, or subject to substantiation rules to guide payroll withholding and reporting.

Approvals

Signed approval lines for the employee, approving manager, and HR representative, with dates and any conditional notes or expiry of the exception.

Step-by-Step: Filling and Approving the Agreement

Follow these steps to complete, approve, and route the HR Per Diem Exception Agreement so payroll can process reimbursements correctly.

01

Prepare Form: Employee or manager completes fields and attaches supporting travel documentation.
02

Manager Approval: Approving manager reviews and signs to confirm business need and budget.
03

HR Review: HR confirms policy alignment and annotates tax treatment instructions for payroll.
04

Payroll Processing: Payroll posts reimbursement to the next eligible pay cycle per the stated tax treatment.

Routing Overview for Electronic Completion

A standard electronic routing reduces handoffs and provides an audit trail of each action and signature.

Upload: Sender uploads the completed agreement and attaches receipts if required.
Place Fields: Add signature, date, and optional verifier fields for manager and HR.
Send to Signers: Route to manager, HR, and employee in the required order.
Store: Save the signed agreement to the employee file and payroll system.

Recommended Digital Workflow Settings

Configure signer order, authentication, and retention to match your compliance and audit needs.

Field	Configuration
Signer Order	Manager → HR → Employee
Authentication	Email link with optional SMS code for higher assurance
Document Retention	Save copy in HRIS and payroll as PDF/A
Notifications	Enable reminders at 3 and 7 days

Digital Signing and System Integration Considerations

Choose e-signature settings that support intent, attribution, and reliable retention while integrating with HR and payroll systems.

Formats Supported: PDF, DOCX accepted
Integrations: Common: HRIS, payroll, document storage
Authentication: Email, SMS, or advanced verification

Use audit trails and secure storage; align authentication strength with internal policy and regulatory needs.

Common Pitfalls to Avoid

Skipping precise dates or leaving time zones unspecified causes incorrect per diem allocation and payroll disputes.
Failing to document the business reason makes exceptions difficult to justify during audits or compliance reviews.
Not specifying tax treatment results in incorrect withholding and potential IRS reconciliation issues for the employer or employee.
Storing only a signed image without an audit trail removes evidence of signer intent and process continuity.

Potential Risks and Compliance Consequences

Incorrect Tax Reporting: May trigger IRS review under IRC §6501(a)

Payroll Errors: Leads to wage statement discrepancies and corrective filings

Policy Violations: Can nullify exception and require repayment

Audit Exposure: Weak documentation increases audit risk

I-9/Employment Records: Retention lapses violate 8 CFR §274a.2

HIPAA Risk: If PHI involved, BAA obligations apply

Key Timing and Processing Expectations

Set clear deadlines for submission and approval so payroll can process reimbursements within the intended tax period and pay cycle.

Employee Submission Window:

Submit requests at least 10 business days before travel or reimbursement where possible

Manager Approval:

Approve within 5 business days to avoid payroll delays

HR Review:

Complete review within 3 business days after approval

Payroll Posting:

Post to the next eligible pay cycle following HR sign-off

Record Retention Start:

Retention begins on agreement execution date

Processing Milestones from Request to Payment

A clear milestone map helps stakeholders understand when action is required and when payroll will reconcile the exception.

01

Request Submitted

Employee files the exception form with travel justification and receipts

02

Manager Approval

Manager reviews business need and approves or denies the request

03

HR Compliance Check

HR confirms tax treatment and policy alignment

04

Payroll Reimbursement

Payroll processes the approved reimbursement per payroll schedule

Comparison: eSignature Costs and Key Capabilities

Pricing and feature availability vary by vendor and plan; the table below summarizes starting price and select capabilities for common eSignature providers.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Real-World Examples of When Exceptions Are Used

Practical examples illustrate why a per diem exception may be needed and how it is documented in practice.

Case Study 1

A sales director traveled to multiple remote sites where hotel options were limited and costly, requiring a higher lodging allowance than policy allows

The manager requested a temporary lodging exception for the trip
The signed agreement recorded adjusted per diem, specified dates, documented receipts, and directed payroll to apply the allowance with taxable treatment where substantiation was insufficient.

Case Study 2

A field technician had an extended multiweek assignment with employer-provided housing, reducing meal costs and requiring a reduced daily meal allowance

HR implemented a prorated per diem exception for the assignment duration
The agreement specified the reduced daily rate, duration, accountability for unspent amounts, and required monthly reconciliations attached to timesheets for accounting.

Practical Tips for Accurate and Efficient Completion

Follow a few practical steps to reduce processing time, improve audit readiness, and ensure consistent payroll treatment.

Use a Standard Template

Maintain a single company template for exceptions that includes fields for tax treatment, attachments for receipts, and clearly labeled approver sections to avoid ad hoc forms and missing data.

Require Supporting Documentation

Attach receipts, travel itineraries, or vendor confirmations when rates differ from policy so HR and payroll can substantiate non-taxable allowances and defend positions during audits.

Document Tax Instructions

State whether payments are taxable or non-taxable and include instructions for payroll withholding and reporting to prevent retroactive corrections and IRS notices.

Store Securely

Keep signed agreements in the HRIS or secure document repository with access controls and an audit trail to meet retention and discovery requirements.

Frequently Asked Questions and Troubleshooting

Answers to common questions about validity, electronic signing, tax treatment, and storage for HR Per Diem Exception Agreements.

Need help? Contact support

Can this be executed electronically?
Yes. Electronic signatures meeting ESIGN Act criteria establish intent and enforceability for most transactions; ensure consent and retention in line with 15 U.S.C. ch. 96 and applicable state UETA rules.
When is a per diem taxable?
Per diem amounts are taxable if not substantiated with receipts or if they exceed federal per diem safe harbors; consult IRS substantiation rules and your payroll tax advisor.
Do approvals need notarization or witnesses?
Not typically for internal HR per diem exceptions; notarization or witnesses may be required only if state law or a specific employer policy demands it.
How long must we retain the agreement?
Retain for at least 3 years for IRS purposes (IRC §6501(a)); if PHI is included, follow HIPAA six-year retention (45 CFR §164.530(j)). State laws may require longer.
What authentication is sufficient for signatures?
Email-based authentication is often adequate; higher-risk scenarios may require SMS, KBA, or multi-factor methods consistent with internal policy and regulatory expectations.
What if payroll treats the payment incorrectly?
Notify HR and payroll immediately to correct withholding or reporting; document corrections and retain amended records for audit trails and potential IRS inquiries.

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