BP-A0369
JUN 10

# OVERTIME AUTHORIZATION

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

MCC New York
(Institution Location)

To: <empty> 5 August , 2019
(Name of Employee)

You are authorized to work overtime as follows:
Day of Week: Monday Date: 5 August , 2019
Starting: 1500 Approximate period: 90 minutes

Purpose: Project planning and administrative duties

Reasons work cannot be accomplished during regular tours of duty:
Shortage of administrative staff

Warden or Authorized Supervisor:<empty>

In accordance with above authorization I certify I worked the following overtime:
Day of Week: Monday Date: 5 August , 2019
Starting: 1500 Approximate period: 90 minutes

and request: Overtime Pay xxxxxxxx
Compensatory Time:<empty>
(Signature of Employee):<empty>

Time verified:<empty> (supervisor's initial)

(To be used where not authorized in advance by Warden)
Approved:<empty>
Warden:<empty>

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.

# OVERTIME AUTHORIZATION (cont.)

(3) To be prepared in Original only, processed in accordance with institutional regulations and filed in payroll folder.

PDF

Prescribed by P3000

EFTA00037247

BP-E369 (Continued)

# *When employee signs he/she should indicate "P" for Overtime Pay or "C" for Com pensatory time

<table><tr><th>Name of Employee</th><th>Date</th><th>Time
IN</th><th>Time
OUT</th><th>P
C</th><th>Signature of Employee</th><th>Supervisor's</th></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></table>

# *When employee signs he/she should indicate "P" for Overtime Pay or "C" for Com pensatory time (cont.)

END FORM

PDF

Prescribed by P3000

EFTA00037248