© 2024 Seyfarth Shaw LLP | www.seyfarth.com Classification Guidebook | 51 The Company has determined that your salary at the time was $[____] per week and has agreed to pay you for these [____] overtime hours at the rate of $[____] per hour [HALF-TIME OR TIME AND ONE-HALF RATE, WHICHEVER IS APPLICABLE, AND, IF HALF-TIME RATE, ADD: because, as you and I have agreed, your salary at that time covered all hours that you worked in any workweek and did not vary from one week to the next even though you sometimes worked more than 40 hours and sometimes less than 40 hours]. Multiplying the agreed-upon overtime hours by this overtime pay rate amounts to $[____] in back wages, before required statutory withholdings. If you accept this amount as constituting full payment for your past overtime hours during the period discuss above, please sign and return the enclosed Acknowledgment of Receipt of Back Wages. Once the Company receives your signed Acknowledgment, you will receive a check for $[____], less statutory withholdings. Should you have any questions, please feel free to contact me. Regards, [SIGNATURE OF MANAGER/HR/LEGAL CONTACT WHO HANDLED BACK WAGE DISCUSSION] Proposed Acknowledgment Form (Do Not Use in California) ACKNOWLEDGMENT OF RECEIPT OF BACK WAGES I, [EMPLOYEE NAME], understand and acknowledge that the Company has decided to provide to me a one-time payment of $[GROSS BACK PAY AMOUNT], minus statutory withholdings, for my employment as a [OLD OR UNCHANGED TITLE], from [RELEVANT PERIOD START DATE, WHICH SHOULD BE TWO YEARS PRIOR TO RECLASSIFICATION or EMPLOYEE’S HIRE DATE IN THE POSITION, WHICHEVER IS LATER] to [RECLASSIFICATION DATE]. This amount, along with what I have received as compensation for my past work as a [OLD OR UNCHANGED TITLE], compensates me fully under federal [and ____ RELEVANT STATE LAW IF THERE IS A STATE OVERTIME LAW] law for the number of hours I worked during that period as a [OLD OR UNCHANGED POSITION TITLE], including pay for hours I may have worked in excess of forty in any workweek. I understand and acknowledge that I performed my work as a [OLD OR UNCHANGED POSITION TITLE] while classified as an exempt employee, meaning I was not entitled to overtime pay under laws applicable to non-exempt, overtimeeligible employees. The Company has chosen, in its sole discretion, to pay this amount to me as I transition into a role that will be classified as non-exempt and in which I will be eligible for overtime pay. I understand how the Company has determined the amount of this payment and acknowledge that the amount is fair and reasonable. I further acknowledge that I have been offered this amount and have accepted it pursuant to these terms. I understand the sensitive nature of this agreement and do not intend to disclose it to others. Employee Signature Date: ___
RkJQdWJsaXNoZXIy OTkwMTQ4