Exempt Survey

State:
Multi-State
Control #:
US-340EM
Format:
Word; 
Rich Text
Instant download

About this form

The Exempt Survey is a legal form used to assess whether an employee qualifies as exempt from overtime pay regulations. This form is distinct from other employment forms as it focuses specifically on the criteria for exemption, incorporating various job responsibilities and decision-making authority that employees must outline to help human resources determine their eligibility for overtime pay protections.

Form components explained

  • Name, department, job title, and date fields
  • Questions regarding supervisory roles and employee management tasks
  • A checklist of job duties to confirm exempt status
  • A section detailing decision-making authority
  • Supervision levels and planning responsibilities
  • Reporting of regular work hours and salary
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When this form is needed

This form should be used when a company needs to determine whether an employee can be classified as exempt from overtime pay. It is particularly useful during employee evaluations, when onboarding new hires, or whenever job responsibilities change that might affect an employee's classification status.

Who this form is for

  • Employees whose exemption status is being evaluated
  • Supervisors who need to submit the survey to the HR department
  • Human resources personnel responsible for classifying employee job roles

Completing this form step by step

  • Provide your name, department, job title, and date at the top of the form.
  • Answer the questions related to the number of employees you supervise and their job titles.
  • Check all applicable activities that pertain to your role on the provided checklist.
  • Detail your primary job duties and the types of decisions you are authorized to make.
  • Explain any special projects or budgeting responsibilities you handle in your position.
  • Indicate your level of supervision and your regular work hours and salary.

Is notarization required?

This form does not typically require notarization to be legally valid. However, some jurisdictions or document types may still require it. US Legal Forms provides secure online notarization powered by Notarize, available 24/7 for added convenience.

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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

Form selector

We protect your documents and personal data by following strict security and privacy standards.

Mistakes to watch out for

  • Failing to fully complete all sections of the survey, which may lead to incorrect classification.
  • Not detailing all job duties and responsibilities, resulting in an incomplete understanding of the role.
  • Underestimating the level of decision-making authority held, which may impact exempt status.

Advantages of online completion

  • Convenient download and access from any device.
  • Editable fields to ensure information can be customized as needed.
  • Reliable templates drafted by licensed attorneys to ensure legal compliance.

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FAQ

Some examples of Exempt research are: anonymous or identifiable surveys or interviews. passive observation of public behavior with or without the collection of identifiers. retrospective and prospective medical chart reviews (allowable under specific criteria for UCI Healthcare Workforce)

Exempt research are human subjects studies that present no greater than minimal risk to subjects and fit into one or more exempt categories (as described below).

Exempt studies involve human subjects research: research involving a living individual about whom data. or biospecimens are obtained/used/studied/analyzed through interaction/intervention, or identifiable, private information is used/studied/analyzed/generated.

To be classified as exempt, the research:Cannot involve any of the exceptions for the exempt categories for research that involves children ; For studies subject to pre-2018 Common Rule requirements: The study cannot involve prisoners as research subjects. Cannot be greater than minimal risk.

Non-Exempt Research (Needs IRB Approval): Any research, inclusive of surveys that involves minors, prisoners, clinical populations; inclusive of any clients in any therapeutic setting/relationship with a potential researcher; and any other vulnerable populations, such as older adults, should undergo IRB review.

Research can be approved as exempt if it is no more than minimal risk and fits one of the exempt review categories as defined by federal regulation 45 CFR 46. Studies that may qualify for Exempt must be submitted to the IRB for review. Exempt reviews are conducted by a member of IRB staff.

In order to establish an individual research project as exempt, an investigator must complete an IRB application. On the IRB application the investigator should indicate the number of the category under which an exemption is claimed. Final determination as to whether a project is exempt rests with the IRB.

No full board review: An exempt protocol does not need full board review; modifications do not need to be reviewed at a full board meeting unless the protocol modifications change the exemption status.

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Exempt Survey