9363210999

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Overtime Request Form

Todays Date*
Date Format: MM slash DD slash YYYY
Employee Name (Person Working the Overtime)*
First Last
Date of Overtime*
Date Format: MM slash DD slash YYYY
Total Number of Overtime Hours*
Detailed Reason for Overtime
Battalion Chiefs Name
First Last
Battalion Chiefs Email*
Date Signed
Date Format: MM slash DD slash YYYY
Battalion Signature*

Phone: 936-321-0999 Email: info@needhamfirerescue.com

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