Employee FLSA Exemption Classification Questionnaire Form
Complete this form to help determine the likely FLSA exemption classification for the employee based on their role, duties, and responsibilities.
Employee job title / position
*
Department / team
*
Primary work location / state
*
Who does the employee report to? (Supervisor role)
*
Primary duties summary
*
Percentage of time spent on exempt-type duties
*
Does the employee regularly supervise other employees?
*
Yes
No
Does the employee have authority to hire, fire, or make recommendations that are given significant weight?
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Yes
No
Does the employee exercise independent judgment on important matters?
*
Yes
No
Additional notes relevant to classification review
Submit
Should be Empty: