Compensatory Time Off Agreement Template printable pdf download

Shepherd University Compensatory Time Off Agreement

This form is to be completed and signed by an employee and the employee’s supervisor each time an employee

is to be awarded Compensatory Time Off (CTO) for overtime work. It is not necessary to complete the form if

the employee will be paid for the overtime work. Also, if flex time is used within the work week, then this form

is not required.

 This original document should be completed and signed. After the comp time is used, the form should

be forwarded to the Human Resources Office. Copies should be filed with the employee’s supervisor

and the employee should maintain a copy for his or her records. CTO time must be used within one year

of when it is accrued.

 In order for CTO to be applied, the supervisor and employee both must agree to that arrangement in

advance of the overtime work. Employees are not required to accept CTO in lieu of overtime pay and

supervisors are not required to give CTO in lieu of overtime pay.

 Please refer to the Shepherd University Staff Handbook and Board of Governors Policy 9 for policies

related to overtime work.

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I agree to accept time off as compensation for overtime work and to use Compensatory Time Off (CTO) in

accordance with Shepherd University policy. I understand that compensatory time may be limited, preserved,

used or paid consistent with the provisions of Shepherd University policy and applicable laws and regulations of

the U.S. Department of Labor, and that my supervisor may require me to take any accrued CTO before or

instead of using annual leave, unless I should be at my maximum annual leave balance.

Employee’s Name (Print):

Employee’s Signature:

Date:

Supervisor’s Name (Print):

Supervisor’s Signature:

Date:

Date Comp Time Accrued:

Total hours employee worked during

week in which CTO was earned:*

Number of Hours Accrued:

Reason:

*This figure will be used to calculate the CTO rate of pay. Non-Exempt employees are entitled to overtime

compensation at the rate of 1.5 times the actual rate for all hours worked in excess of 40 during the work week. Hours

worked between 37.5 and 40 are compensated at the straight time rate. Holidays and sick or annual leave hours are not

hours worked. This same formula applies to the application of CTO. Exempt employees do not receive overtime

compensation for regular overtime work but shall be given substitute time off on an hour-for-hour worked basis if they

work a holiday.

Revised 05-25-2016

Compensatory Time Off Agreement Template