Substituting Work Day Request Form printable pdf download

SUBSTITUTING WORK DAY REQUEST FORM

FOR

PUBLIC SAFETY

Employee Name (Please print) _______________________________ Employee # ___________

I am requesting to substitute one day of work for another day as a result of a personal obligation

on:

Scheduled Day of the week __________________________

Date ____________________

Substituted Day of the week __________________________

Date ____________________

I will substitute the day within the same workweek as follows: (Fill in the date you are

scheduled to work and the substituted date you are going to work.)

I understand that:

1. Any substituted day I work will not be paid at an overtime rate;

2. A separate written request is required for each substituted scheduled workday. If an

employee knows in advance that he or she will be requesting substituted days to their

scheduled workday for a personal obligation that will recur at a fixed time over a

succession of weeks, the employee may request to substitute scheduled days for up to

four (4) weeks in advance; provided, however that the substituted day of work must be

performed in the same week that the scheduled day is lost.

3. My substituted work day request must be approved in writing before I change my

regularly scheduled worked day off;

4. If I take time off and I am unable to work the substituted day for any reason, the hours

missed will normally be unpaid;

5. If I work the substituted day before my regularly scheduled day that I plan to take off, I

must take that time off, even if I no longer need the time off for any reason;

6. USD does not encourage, discourage, or solicit the use of switching regularly scheduled

days of work.

Employee Signature_______________________________ Date Submitted _______________

Supervisor’s Signature _____________________________ Date _______________________

Supervisor’s Title _________________________________________

The employee will still enter their time worked in Kronos and payroll will make the adjustment

once the Substituted Work Day Request Form has been received. Any questions, please contact

the Payroll Department at extension 4818.

Please forward to the Payroll Department in Maher Hall 112 or fax (619) 260-2988 prior to the

end of the pay period.

Substituting Work Day Request Form