EFTA00143201



BP-A0369
JUN 10


OVERTIME AUTHORIZATION

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

# MCC NEW YORK

# (Institution Location)

To SMITH, T. PP 16

<table><thead><tr><th>AUGUST 17</th><th>2019</th></tr></thead></table>

[Name of Employee]

You are authorized to work overtime as follows:

Day of Week: SEE ATTACHED Date: SEE ATTACHED 2019

Starting: VARIES

Approximate period: **VARIES** minutes

Purpose: PEST CONTROL

Reasons work cannot be accomplished during regular tours of duty: FOGGING MUST BE COMPLETED AFTER HOURS

Rocco Lupo USA

92302145A1

Warden or Authorized Supervisor

In accordance with above authorization I certify I worked the following overtime:

Day of Week: ___ SEE ATTACHED

<table border="1"><tr><td>Date:</td><td>SEE ATTACHED</td><td>2017</td></tr></table>

Starting: VARIES

Approximate period: VARIES minutes

and request: Overtime Pay ___

Compensatory Time ___

SMITH, T.

Time verified (supervisor's initial)

(Signature of Employee)

(To be used where not authorized in advance by Warden)

Approved:





Warden

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.

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

PDF

Prescribed by P3000

EFTA00143202

BP-E369 (Continued)

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

<table><thead><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&#39;s</th></tr></thead><tbody><tr><td></td><td></td><td></td><td></td><td>VA</td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td>VA</td><td></td><td></td></tr><tr><td>T. SMITH</td><td>08/04/2019</td><td>11:00 am</td><td>7:00 pm</td><td>F</td><td></td><td></td></tr><tr><td>T. SMITH</td><td>08/15/2019</td><td>5:00 am</td><td>12:00 pm</td><td>P</td><td></td><td></td></tr><tr><td>T. SMITH</td><td>08/16/2019</td><td>8:00 pm</td><td>11:30 pm</td><td>P</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></tbody></table>





END FORM

PDF

Prescribed by P3000

EFTA00143203

<table><tr><td>EMPLOYEE:</td><td>PP: 16/2019</td><td>SHIFT: D/W</td><td>DAYS OFF: Fri/Sat.</td></tr></table>

<table><thead><tr><th>Week 1</th><td>8000 1600</td><td>1100 1900</td><td></td><td></td><td>1100 1900</td><td>1100 1900</td><td>8000 1600</td><td></td><td></td><td></td><td>1100 1900</td><td>1100 1900</td><td></td><td>1100 1900</td><td>1100 1900</td><td>Wee 2</td></tr><tr><th></th><td>S</td><td>M</td><td>T</td><td>W</td><td>TH</td><td>FR</td><td>S</td><td>CODE</td><td>TYPE OF DUTY</td><td>CODE</td><td>S</td><td>M</td><td>T</td><td>W</td><td>TH</td><td>FR</td><td>S</td></tr></thead><tbody><tr><td>DATE</td><td>8</td><td>8</td><td>8</td><td>8</td><td>8</td><td>8</td><td>8</td><td></td><td></td><td></td><td>8</td><td>8</td><td>8</td><td>8</td><td>8</td><td>8</td><td>DAT</td></tr><tr><td></td><td>4</td><td>5</td><td>6</td><td>7</td><td>8</td><td>9</td><td>10</td><td></td><td></td><td></td><td>11</td><td>12</td><td>13</td><td>14</td><td>15</td><td>16</td><td>17</td></tr><tr><td></td><td></td><td>8</td><td></td><td></td><td>8</td><td>8</td><td>8</td><td>01/1</td><td>REGULAR / SH1</td><td>01/1</td><td></td><td>8</td><td></td><td></td><td>8</td><td>8</td><td>8</td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>01/2</td><td>REGULAR / SH2</td><td>01/2</td><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><td></td><td>01/3</td><td>REGULAR / SH3</td><td>01/3</td><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><td></td><td>04/1</td><td>SUNDAY / SH1</td><td>04/1</td><td>8</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><td></td><td>04/2</td><td>SUNDAY / SH2</td><td>04/2</td><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><td></td><td>04/3</td><td>SUNDAY / SH3</td><td>04/3</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>8</td><td></td><td></td><td></td><td></td><td></td><td></td><td>61</td><td>ANNUAL LV</td><td>61</td><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><td></td><td>62</td><td>SICK LV</td><td>62</td><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><td></td><td>62/62</td><td>SICK LEAVE -FFLA</td><td>62/62</td><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><td></td><td>61/66</td><td>Time Off Award</td><td>61/66</td><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><td></td><td>64</td><td>COMP USED</td><td>64</td><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><td></td><td>66</td><td>HOLIDAY OFF</td><td>66</td><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><td></td><td>21</td><td>OVERTIME</td><td>21</td><td></td><td>6</td><td></td><td>8</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>32</td><td>COMP EARNED</td><td>32</td><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><td></td><td>66/1</td><td>HOLIDAY OFF/SH1</td><td>66/1</td><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><td></td><td>66/2</td><td>HOLIDAY OFF/SH2</td><td>66/2</td><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><td></td><td>66/3</td><td>HOLIDAY OFF/SH3</td><td>66/3</td><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><td></td><td>31/1</td><td>HOLIDAY WRK/SH1</td><td>31/1</td><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><td></td><td>31/2</td><td>HOLIDAY WRK/SH2</td><td>31/2</td><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><td></td><td>31/3</td><td>HOLIDAYWRK/SH3</td><td>31/3</td><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><td></td><td>67</td><td>COP- INJURY LV</td><td>67</td><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><td></td><td>63</td><td>RESTORED LV</td><td>63</td><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><td></td><td>65</td><td>MILITARY LV</td><td>65</td><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><td></td><td>61/TC</td><td>VLTP DONATION</td><td>61/TC</td><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><td></td><td></td><td>TRAINING</td><td></td><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><td></td><td></td><td>AUGMENTATION</td><td></td><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><td></td><td>40</td><td>TOTAL HOURS</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>54</td></tr></tbody></table>

<table><thead><tr><th>OVERTIME DETAILS:</th><th>08/12/2019, 0500 -1100 hours, 5 hrs.</th><th>08/14/2019, 1100 -1900 hours, 8 hrs.</th></tr></thead></table>

NOTES:

TIMEKEEPER EMPLOYEE SUPERVISOR