Overtime request form
An overtime authorization form with the date, planned hours, reason and manager approval, with hours totaled for you.
- ๐บ๐ธ US format ยท Letter size
- Free
This is a sample form. Check that the terms and pay match federal and state labor rules and your company policy.
Fill in what you need. The preview updates as you type.
What you type is not saved on our server.
This form counts hours, not pay
Under the Fair Labor Standards Act, nonexempt employees earn at least 1.5 times their regular rate for hours over 40 in a workweek. Some states (California, for example) also have daily overtime. Whether these hours are paid at the overtime rate depends on your status and the rest of your week, so the form only totals the hours.
1 / 1
Overtime Request
| Manager | Human Resources |
| Employee | Jordan Lee | Department | Marketing, Associate |
|---|---|---|---|
| Employee ID | EMP-0231 | Date | October 14, 2026 |
| Reason | The Q4 campaign assets are due to the agency on October 20. Review feedback came back late, so the revisions and final checks need three evenings and part of Saturday. | ||
| Total overtime hours | 11 hours (11 h) | ||
| Date | Start | End | Break | Hours | Work to be done |
|---|---|---|---|---|---|
| Thu 10/15/2026 | 5:30 pm | 8:30 pm | ย | 3 | First round of ad revisions |
| Fri 10/16/2026 | 5:30 pm | 10:00 pm | 30 min | 4 | Apply agency feedback, export files |
| Sat 10/17/2026 | 10:00 am | 3:00 pm | 60 min | 4 | Final checks and delivery |
| ย | ย | ย | ย | ย | ย |
| ย | ย | ย | ย | ย | ย |
| ย | ย | ย | ย | ย | ย |
Hours = end time minus start time minus the unpaid break. An end time earlier than the start time is counted as the next day.
I request approval to work the overtime hours listed above. October 14, 2026 Employee signature: Jordan Lee To: Human Resources |
How to use it
Add one line per date with the start time, end time and any unpaid break, and the form works out the hours for each line and the total. Times can be typed as 5:30 pm or 17:30. If the end time is earlier than the start time, the form treats it as the next morning. Say in one or two sentences why the work cannot happen during normal hours.
Submit before the hours are worked if your employer requires pre-approval, which most do. After the work is done, record the actual hours on your timesheet.
Things to watch
This is a request to work, not a pay calculation. Overtime pay applies to nonexempt employees after 40 hours in the workweek under federal law, and some states add daily limits. Salaried exempt employees usually do not receive overtime pay but may still need approval to work extra hours. If you are unsure of your status, ask HR.
Calculators that go with this
Frequently asked questions
Why does the form not calculate overtime pay?
Overtime pay depends on your total hours for the whole workweek, your regular rate and whether you are exempt, none of which are on this form. Your payroll system or timesheet handles that.
Can I put several dates on one form?
Yes, up to ten. Managers usually prefer one form per week or per project so the total is easy to compare with the timesheet.
How many sign-off boxes do I need?
Match your company's approval chain. A small team often uses one box for the manager. Larger companies add Reviewed by and Approved by. Pick None if approvals happen by email and you only need the body of the form.
Is what I type saved anywhere?
No. Everything stays in your browser and nothing is sent to our server. If you refresh the page it is gone, so print, save a PDF or download the DOCX when you are done.