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FLSA OT EMPLOYEE SURVEY

Fill this form out for immediate submission to our attorneys or download (PDF) or (RTF) and fax to 410-653-9061 or email.

						  

Background Questions:

Full name:
Email:
Business phone number:
Business address:
What Agency do you work for?:
Job Title:
Job series:
Current grade:
Are you currently classified as FLSA Exempt or non-exempt?
(check your most recent SF-50)
The best time and day of the week to reach you is:


Briefly list and describe all positions, titles, grades and job series that you have held, including detailed dates you have held with the Federal government.

List your major and minor job duties (indicate which are major, which are minor) at each job you have held (and AT EACH GS LEVEL) since January 2001, estimating the amount of time you perform each duty (daily, weekly, monthly, etc.). (Minor duties may include activities not included in position description that you find yourself performing on a frequent basis.)

State if your job duties have changed since January 2001 and if so, how?

Do you supervise or lead the work of any other employee? If so, how many? If so, describe how you supervise the other employee(s), state their grade and job series, and estimate the amount of time you spend supervising them.

To qualify for your position, is it required, to the best of your knowledge, to have a 4-year degree or any other specialized prolonged course of institutional instruction, training, or study?

Do you use guidelines in your work? If so, describe the guidelines and how detailed they are.

Are you allowed to deviate from the guidelines? Do you need to get approval from a higher up to do so?

Describe how your work goals are set. Does your supervisor give you assignments?

Is your work reviewed by your team leader or supervisor? How closely?

Do you have any autonomy in your work?

How much paid overtime do you estimate you have worked since January 2001?

Have you worked any compensatory time (Acomp time@) since January 2001? If so, describe the circumstances surrounding such work, such as other options available to you to perform such work.

Have you come in to work early or left work late since January 2001, without getting compensation (ie, without getting paid overtime, comp time, credit hours, religious comp, etc.)? Describe the type of work you have performed and estimate the amount of hours you have worked without overtime or other compensation.

Have you performed other unpaid overtime since January 2001, such as activities not performed during work hours but necessary for the job such as cleaning tools, changing uniforms, responding to beeper/cell phone calls, voluntarily coming in early and staying late, or answering phones during break time (Asuffered and permitted@ overtime)? Describe the type of work you have performed and estimate the amount of hours you have worked without overtime or other compensation.

Are there any other employees who do the same work that you do, are the same grade, job series, etc.?

Is there any other information you think is relevant to this case? Be as detailed as you can be.

If you would like a copy of this form and your responses emailed to you, enter it in here:

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Disclaimer:
No information or materials posted herein are intended to constituted legal advice, nor can we guarantee the accuracy of posted information, especially as to each individual situation. Snider & Associates does not endorse any product, service, website, or firm. Visiting, getting information from or submitting a form through this site does not constitute formation of any attorney-client relationship; legal counsel should always be consulted. You should consult an attorney with regard to your individual circumstances and get any agreement in writing.

The attorneys in our firm have bar admissions including state courts in Maryland and New York. Our attorneys also hold among them admissions to the Court of Federal Claims, Federal District Courts for the Districts of Maryland, New York and District of Columbia; the Federal Circuit Courts of Appeal for the Fourth Circuit, Ninth Circuit, Federal Circuit, the Circuit Court of Appeals for the Armed Services and the Supreme Court of The United States. Our attorneys are able to practice before Arbitrators, EEO Administrative Judges and MSPB Administrative Law Judges anywhere in the United States.

© 2002, 2003, 2004, 2005 Snider & Associates, LLC - all rights reserved

 
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