NYC 9/11 Public Portal Document
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31 DEPARTMENT OF ENVIRONMENTAL PROTECTION
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59-17 jusenox K.VD, IHH FLOOR, CORO.XA, SEW YORK 113E8-S107
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OVERTIME AUTHORIZATION FORM
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Distribution Hz Week Ending:,
Weekly Anendance
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NORSUL WORK WXEK- ■HOURS
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total overtime S% annual salary in has employee exceeded 5%. rc^tirement eligibility
pres'ious 12 months hours ———— in O.T. ? (yes / no)------- month year
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Date(s) Location(s) Reason(s)
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str. prem. str. pre. hot.
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Report Total!
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Authorized &j^proval Slgnaturc(«]n
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Bureau CiiicDCommissioner’s Designee Approved Date
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