WAIVER OF 25 HOUR / WEEK LIMIT - EXTRA HELP EMPLOYEE
Employee Name: Department: Position:
Type of Exception Requested:
Seasonal Employee: An extra help employee who works a seasonal job (tied to an actual season, not just part-year) for a portion of the year and who will not perform any work for the County for at least 26 consecutive weeks between seasons*.
- Employees must be terminated for the 26 weeks that they are not performing any work.
*definition is subject to future change as terminology is further defined by the ACA
Short Term Employee: Employee may work any number of hours per day but employment terminates on or before the 59th calendar day.
Variable Hour Employee: An employee who works various hours per week, or non-consecutive weeks, whose average hours per week (including 0 hours) in the measurement period* will not exceed 29 hours.
*for new employees, the measurement period is their first 10 pay periods, even if no wages are paid.
Reason Why Exception is Needed:
Department is in the process of recruiting for a permanent position (please give details below).
Permanent employee is on an extended leave of absence (please give details below).
Other (please give details below).
Other Information:
Period of time/dates requesting a waiver of the 25 hour limit:
At the end of the approved period the employee will be terminated. Tentative Date of Termination:
Currently recruiting/interviewing - Depending on the results of the recruitment the employee will either be hired
permanently or terminated. Tentative date process will be completed:
Department Head Signature ______________________________________ Date
ATTACH A PROPOSED WORK SCHEDULE FOR THE EXTRA HELP EMPLOYEE. Incomplete forms and/or forms without a work schedule attached will be automatically returned to the Department Head.
Submit the completed form and attached work schedule to the Human Resources Director.
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HUMAN RESOURCES / ADMINISTRATIVE OFFICE USE ONLY
Form is incomplete or attached work schedule is missing. - Returned to Department Head.
Exception approved as requested through DATE.
Exception approved per Administrative comments/conditions through DATE
Exception disapproved
Administrative Comments/Conditions: ______________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
County Administrative Officer Human Resources Director
Distribution If Approved Distribution If Disapproved
Original to HR Original to Department
Copy to Payroll Copy to HR
Copy to Department Rev 06/ 2014