EFTA00143204



BP-A0369
JUN 10


OVERTIME AUTHORIZATION

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

MCC NEW YORK

# (Institution Location)

To: 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:

<table border="1"><tr><td>Day of Week:</td><td>SEE ATTACHED</td><td>Date:</td><td>SEE ATTACHED</td><td>2019</td></tr></table>

Starting: VARIES

Approximate period: SEE ATTACHED minutes

Purpose: TO WORK VARIOUS SHIFTS





<table border="1"><tr><td>Reasons work cannot be accomplished during regular tours of duty:</td><td>NO OTHER STAFF AVAILABLE</td></tr><tr><td>NE COOK SUPERVISOR ON AL AND ONE COOK SUPERVISOR ON SL</td><td></td></tr></table>

Rocco Lups, FEA

92302145A1

Warden or Authorized Supervisor





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

Day of Week: SEE ATTACHED

Date: SEE ATTACHED 2017

Starting: SEE ATTACHED

<table><thead><tr><th>Approximate period:</th><th>SEE ATTACHED</th><th>minutes</th></tr></thead></table>

and request: Overtime Pay ___

Compensatory Time ___

A. WILLIAMS A.

(Signature of Employee)

Time verified ___ (supervisor's initial)

Approved:

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





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.

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EFTA00143205

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>SE</td><td></td><td></td></tr><tr><td>08/12/2019</td><td>5:00 am</td><td>11:00 am</td><td>P</td><td></td><td></td><td></td></tr><tr><td>08/14/2019</td><td>11:00 am</td><td>7:00 pm</td><td>P</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></tbody></table>







END FORM

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