REQUEST FOR EXTRA DUTY PAY FOR ADMINISTRATORS
MEM-4406.1 ATTACHMENT N
August 4, 2008
REQUEST FOR EXTRA DUTY PAY FOR ADMINISTRATORS
To: Local District Superintendent/Division Head Date:
From:
Name Title Location
Employee Information
Name of Administrator: Empl. #
Current Position: Assignment Basis: Location:
Proposed Classification: Professional Expert [ ] X/Z Basis [ ] Other [ ]
Provide description of services and rationale:
Dates of services: To: From: Days/Time of Services:
Proposed Hourly Rate: Total Hours: Total Compensation:
Are non-administrative employees being compensated for similar services? Yes No
Classification: Hourly Rate of Pay:
Program name to be charged: Program Code:
For important information regarding criteria and guidelines for qualifying for professional expert and X/Z basis pay, please refer to Personnel Policy Guide E12, Employment of Professional Experts.
This form must be submitted with a Request for Personnel Action “Greenie" and a Professional Expert Application form if applicable.
Approved Not Approved District Superintendent/Division Head District Date
LAUSD/HR Form 9051 Revised 8/04
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