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Get CA CalHR 183 (Formerly DPA 183) 2016-2024

Alternate Work Week Agreement California Department of Human Resources State of California 1. Employee Information Employee Name Position Division Effective Date Today s Date Please indicate which Alternate Work Week Schedule you are requesting check one. 9/8/80 Work Schedule Regular Day Off RDO Monday - Friday Date of first RDO Work schedule for 8-hour day i*e* 8 00 a*m* - 5 00 p*m* 4/10/40 Work Schedule Regular Day Off RDO Monday - Friday Other Specify schedule and work hours If you are on a 9/8/80 Alternate Work Week Schedule your work week for overtime purposes will start mid-day on your regular day off RDO. This change is being made for the purposes of computing your 40-hour work week and any overtime compensation due to you under the provisions of the Fair Labor Standards Act FLSA. In signing this agreement and in accordance with the provisions of the FLSA you agree to permanently maintain your agreed upon alternate work week schedule. Periodic changes will not be permitted unless you are placed on jury duty military leave or non-industrial disability leave at which time you must return to a Monday-Friday 8 hour day work schedule. This agreement may be cancelled at any time by either you or the Department. Failure to comply with the procedures as outlined in the CalHR Alternate Work Week Policy including maintaining a minimum of 40 hours of leave credits or other paid leave other than sick leave will cause you to be removed from your alternate work schedule and return you to a normal Monday - Friday 5/8/40 work week. 3. Approval I have read and understand the above terms and conditions of the alternate work week schedule and understand that this agreement is made in accordance with the provisions of the FLSA. I also acknowledge receipt of CalHR s policy on Alternate Work Week Schedules and understand a copy of this agreement will be placed in my official personnel file for audit purposes. I further understand that any excess hours accrued as a result of this schedule will be compensated as straight time when paid by lump sum and any deficit hours will be charged to vacation holiday credit excess hours personal leave annual leave CTO or approved dock. Employee Signature Division Chief Signature CalHR 183 Supervisor Signature Personnel Officer Signature Page 1 of 1 rev 04/2016. 9/8/80 Work Schedule Regular Day Off RDO Monday - Friday Date of first RDO Work schedule for 8-hour day i*e* 8 00 a*m* - 5 00 p*m* 4/10/40 Work Schedule Regular Day Off RDO Monday - Friday Other Specify schedule and work hours If you are on a 9/8/80 Alternate Work Week Schedule your work week for overtime purposes will start mid-day on your regular day off RDO. This change is being made for the purposes of computing your 40-hour work week and any overtime compensation due to you under the provisions of the Fair Labor Standards Act FLSA. This change is being made for the purposes of computing your 40-hour work week and any overtime compensation due to you under the provisions of the Fair Labor Standards Act FLSA. In signing this agreement and in accordance with the provisions of the FLSA you agree to permanently maintain your agreed upon alternate work week schedule. .

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