Overtime Extra Working Hours Claim Form.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	R	S
1									MSD-PFSU-08/V-02/R-00/ED-01042024
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3						MANAGEMENT SERVICES DIVISION											Notes:	Kindly download this file to fill up the form. Go to File > Download > Microsoft Excel.
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8	APPLICATION FORM FOR OVERTIME (OT) / EXTRA WORKING HOURS (EWH)
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10	Please tick where applicable										Please fill up:
11		Overtime Claim									MONTH:
12		Extra Working Hours Claim									YEAR:
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14	PART A: INSTRUCTION TO DO OVERTIME/EXTRA WORKING HOURS (to be completed by the Head of Department / Immediate Supervisor prior to the assignment of duty.)
15	Name											Staff No.
16	Position
17	K/C/D/I/O/M
18	Status covering (Please tick)			The staff assigned is on covering assignment.
19	Status covering (Please tick)			The staff assigned is not on covering assignment.
20	Source of budget (Please tick) Please make sure the source of budget is utilised within the allocated budget approved prior to OT/EWH instruction.							Operating Budget			Payment Cost Centre Code
21								Trust Fund			Project Code
22	Signature & Official Stamp Immediate Supervisor / Head of Department											Date
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24	PART B: DETAILS CLAIM (to be completed by the staff assigned for OT/EWH) Staff on covering assignment, the calculation will be started 2 hours 15 minutes after end of working hour. Please attach the supporting document i.e. verified attendance record.
25	Handphone No.				Basic Salary + Housing Allowance + Civil Service Allowance/ Entertainment Allowance + COLA								RM
26	Phone Extension No.									Salary Grade
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28	DATE/ DAY	PARTICULAR (TASK ASSIGNED)		Actual FWH		OVERTIME		NORMAL DAY (1.5)	SATURDAY			SUNDAY			PUBLIC HOLIDAY
29				(7.30 am – 6.00 pm)		OVERTIME			Normal Hours		OT	Normal Hours		OT	PUBLIC HOLIDAY
30				From	To	From	To		1 - 4 (0.5)	> 4 (1.0)	> 8 (1.5)	1 - 4 (0.5)	> 4 (1.0)	> 8 (2.0)	8 (2.0)	> 8 (3.0)
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41	Total Hours							0	0	0	0	0	0	0	0	0
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43	GRAND TOTAL HOURS CLAIMED :				0	HOURS.
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45	I hereby declare the above claim is true.
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47	Signature of Applicant
48	Date:
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50	PART C: CONVERSION OF OVERTIME TO SUBSTITUTIONAL LEAVE (OPTIONAL)
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52		I wish to apply for the 1st eight (8) hours / subsequent eight (8) hours of Overtime to a Substitutional Leave.
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54	Disclaimer:		Please ensure that the claim is true and any false claim made may lead to disciplinary offence and in
55			accordance to IIUM Anti-Bribery Management System.
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57	Signature of Applicant
58	Date:
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60	PART D: APPROVAL FROM HEAD OF DEPARTMENT (HOD) / IMMEDIATE SUPERVISOR (IS)
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62	Disclaimer:		1. The staff and HOD/IS are responsible to ensure that the OT/EWH claimed is true and justified for
63			payment purposes.
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65			2. To safeguard the approving authority from approving false or unjustified claims, the HOD/IS shall
66			ensure that consistency, transparency and integrity are upheld during the approval.
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68								(For claim on special assignment, if any)
69	I hereby recommend the above claim.							I hereby recommend the above claim.
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71	(Signature & Official stamp)							(Signature & Official stamp)
72	Immediate Supervisor 1							Immediate Supervisor 2
73	Date:							Date:
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75				I hereby approve the above claim.
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77				(Signature & Official stamp)
78				Dean/Director/Head of Department
79				Date:
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81	PART D: FOR OFFICE USED (Payroll and Financial Services Unit, MSD)
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83	Date Received
84	Date Processed
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