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OVERTIME AND LEAVE AUTHORIZATION FORM
Employee Name:
Title:
Department:
Director/Supervisor:
51 Dineen Drive
Fredericton, NB
E3B 5G3
Type of Leave Request Leave With/Without Pay Requested Start Date Requested End Date Total Number of Days Requested
Leave of Absence Request
For Departmental Use Only
Supervisor's Signature:Employee's Signature:
Authorization Date:
*Authorized by Director of
Human Resources (If Applicable):
Overtime Request
Request Authorization
Type of Overtime Date Requested Start & End Time
Estimated Overtime
Hours Requested
Reason for Overtime Request
NOTE: Overtime will only be paid for actual time worked to a maximum of the approved total hours
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