[Your Company Name]
[Your Company Address]
[Date]

1. Title

Employee Overtime Waiver for Exempt Employees

2. Purpose

This waiver clarifies the status of the employee regarding their classification as an exempt employee under the Fair Labor Standards Act (FLSA) and confirms their understanding of the implications of waiving overtime pay.

3. Definitions

• Exempt Employee: An employee who is exempt from overtime pay under applicable federal and state laws due to their job duties and salary level.

• Overtime Pay: Compensation for hours worked over 40 in a workweek at a rate of 1.5 times the regular hourly rate.

4. Employee Information

• Employee Name: ________________________________

• Employee Job Title: ___________________________

• Department: __________________________________

• Employee ID (if applicable): ___________________

5. Acknowledgment of Exempt Status

• I acknowledge that I am classified as an exempt employee based on my job duties and salary level, and I understand that I am not entitled to overtime pay under the Fair Labor Standards Act.

6. Waiver of Overtime Pay

• I voluntarily waive my right to overtime pay for hours worked beyond 40 hours in a workweek.

• This waiver does not affect my entitlement to my regular salary for hours worked.

7. Terms of Waiver

• This waiver is effective as of [Start Date] and remains in effect until terminated by either party with written notice.

• The waiver applies to all hours worked in excess of 40 hours per week while employed in my exempt position.

8. Employee Rights

• I understand that I have the right to:

  • Request clarification of my exempt status.

  • Review the terms of this waiver with legal counsel before signing.

  • Revoke this waiver at any time in writing, subject to the notice period outlined above.

9. Employer Responsibilities

• [Your Company Name] agrees to provide a clear job description and maintain records of hours worked, in compliance with applicable laws.

10. Signature

By signing below, I acknowledge that I have read, understand, and voluntarily agree to the terms of this Employee Overtime Waiver.

• Employee Signature: ________________________________

• Date: ________________________

• Employer Representative Signature: __________________

• Date: ________________________

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