Nurse Overtime Calculation Form
Use this form to enter nurse work details and calculate total overtime pay for a specific pay period.
Nurse Name
*
First Name
Last Name
Department/Unit
*
Pay Period Start Date
*
-
Month
-
Day
Year
Date
Pay Period End Date
*
-
Month
-
Day
Year
Date
Shift Date
*
-
Month
-
Day
Year
Date
Regular Hours Worked
*
Overtime Hours Worked
*
Hourly Base Rate ($)
*
Overtime Multiplier
*
Total Overtime Pay
Calculate Overtime Pay
Should be Empty: