REST & RECOVERY PREMIUM REQUEST

Any manager who requires a non-exempt employee to work through some or all of a 30-minute meal period provided under this policy, or requires the employee to take a late meal period, must immediately notify administration so that the employee can be compensated correctly. Any non-exempt employee who feels it is required to work through some or all of a 30-minute meal period or who is required to take a meal period later than the fifth hour of a workday, or who is required to take a second meal period later than the tenth hour of a workday, should complete a California Meal Period and Rest and Recovery Period Premium Request/Authorization Form and submit it to administration by no later than the end of the pay period to ensure they are properly compensated. 

Otherwise, the Company will assume that any non-exempt employee who fails to record a timely meal period, or who records a less-than-30-minute meal period, or takes and records a late meal period, did so voluntarily.

If you need to complete this form offline, use the button below to download the form.

DOWNLOAD | Rest & Recovery Premium Request Form

Submit this form for each date the meal or rest period was missed.

    Required to work through some or all of my first, 30-minute meal periodRequired to take my meal period after the fifth hour in the workdayRequired to work through some or all of my second, 30-minute meal periodRequired to take my second meal period after the tenth hour in the workdayNot authorized and permitted to take first rest periodNot authorized and permitted to take second rest periodNot authorized and permitted to take third rest periodNot authorized and permitted to take fourth rest periodMissed Recovery PeriodNot authorized to take 5-minute recovery period(s) to avoid heat illness

    Agree