Lunch Break Waiver PDF Details

If you're like most people, you take a break for lunch during the day. But what if your job requires you to stay on site during your lunch break? If that's the case, you may need to fill out a lunch break waiver form. This form allows your employer to waive their requirement that you take a break for lunch. Let's take a closer look at this form and see what it entails.

Below, you will find a number of information about lunch break waiver PDF. You'll have the projected time it might require you to fill in the form as well as extra details.

QuestionAnswer
Form NameLunch Break Waiver
Form Length1 pages
Fillable?Yes
Fillable fields5
Avg. time to fill out1 min 15 sec
Other namesmeal break waiver, meal break waiver agreement, meal waiver, california break waiver form

Form Preview Example

Meal Break Waiver Form

Employee Name: _________________________________

ID Number: ___________

(print name)

 

Waiver Effective Date: ___________

 

I understand that under California Labor Law, after a work period of 5 hours, I am entitled to receive an unpaid meal break of not less than 30 minutes during which I am relieved of all duties.

I give my consent that I may waive my 30-minute unpaid meal break only when my work and/or scheduled shift will be completed in 6 hours or less in one workday. I understand that if my shift exceeds 6 hours, I am required to take an unpaid meal break of at least 30 minutes.

In order for this waiver to be valid, my supervisor must also authorize the waiver in writing by signing below.

Employee Authorization

Employee Signature: ____________________________

Date: _____________

Supervisor Authorization

Supervisor Signature: ___________________________

Date: _____________

Please return the completed Meal Break Waiver Form to the Payroll Office, located in Filippi Hall (Administrative Building). Be sure to keep a copy for your department on file.

3/2012

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Related Resources

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