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On-Duty Meal Break or Waiver of Meal Break

PART ONE

The law requires all non-exempt (hourly) employees to take at least a thirty (30) minute meal break if they work more than five (5) hours per day. This meal break may only be waived under the following circumstances:

1. Waiver of Meal Break for a 6 Hour Workday

• An employee whose regularly scheduled workday is completed in six (6) hours may voluntarily choose not to take the meal break.

2. Waiver of Meal Break for a 10 to 12 hour Workday

• If an employee works ten (10) or more hours but less than twelve (12) hours on a workday, he/she may waive the second required meal break if (a) he/she took the first meal break and (b) there is mutual consent from the employer and the employee.

PART TWO

Eligible employees must complete the appropriate section(s) below, sign the form and return it to Woods Humane Society.

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|Waiver of Meal Break for 6 Hour Workday |

|My workday is completed in six (6) hours and I waive my right to a meal break. This agreement will remain in effect unless I cancel it, which can be |

|done at any time by giving written notice to Woods Humane Society. |

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|Employee Name (Please Print): ________________________________ |

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|Employee Signature: _________________________________________ Date: __________________________ |

|Waiver of Meal Break for a 10 to 12 Hour Workday |

|I work ten (10) or more hours per day but less than twelve (12). I take my first meal break but waive my right to a second meal break. This agreement|

|will remain in effect unless I cancel it, which can be done at any time by giving written notice to Woods Humane Society. |

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|Employee Name (Please Print): ________________________________ |

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|Employee Signature: _________________________________________ Date: __________________________ |

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