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FLSA: Exemption Questionnaire

    

 

Note to Employers: This questionnaire serves as a basic outline for an employers initial analysis of positions being considered for exemption under the FLSA and is meant to serve as one of several tools in an employers analysis. Job titles are insufficient to determine exempt status.  SHRM strongly recommends that employers have legal counsel review their analysis efforts and exemption decisions.

Position: __________________________________

Employee: __________________________________

Date: __________________________________

Completed by: __________________________________

Completion of this questionnaire helps determine the exemption status of a position. Check the appropriate exemption (Executive, Administrative, Professional, Computer-Related, Outside Sales and Highly Compensated). Then check all boxes under the selected exemption that are applicable. To qualify for an exemption, all boxes must be checked for that exemption. To access the Department of Labor (DOL) online resources for FairPay (CFR 29, Part 541), click here.

EXECUTIVE (examples: chief executive officer, controller, vice president, director)

Regularly receives a predetermined amount constituting all or part of the employees salary, which is not subject to reduction because of variations in the quality or quantity of work performed. To link to the DOL salary basis information, click here.

Is paid at least $23,660 annually ($455 weekly).

Primary duty consists of managing the enterprise or a customarily recognized department or subdivision of the enterprise.

Customarily and regularly directs the work of two or more full-time employees or their equivalents (for example, one full-time employee and two half-time employees).

Has the authority to hire or fire other employees OR makes recommendations that carry particular weight as to the hiring, firing, advancement, promotion or any other change in status of other employees.

To link to the DOL Executive Exemption information, click here.

ADMINISTRATIVE (examples: manager, supervisor, administrator)

Regularly receives a predetermined amount constituting all or part of the employees salary, which is not subject to reduction because of variations in the quality or quantity of work performed. To link to the DOL salary basis information, click here.

Is paid at least $23,660 annually ($455 weekly).

Primary duty consists of performing office or nonmanual work directly related to the management or general business operations of the employer or the employers customers.

Work includes the exercise of discretion and independent judgment with respect to matters of significance.

To link to the DOL Administrative Exemption information, click here.

PROFESSIONAL: LEARNED AND CREATIVE (examples: accountant, nurse, engineer, composer, singer, graphic designer)

Regularly receives a predetermined amount constituting all or part of the employees salary, which is not subject to reduction because of variations in the quality or quantity of work performed. To link to the DOL salary basis information, click here.

Is paid at least $23,660 annually ($455 weekly). Note: For teachers, licensed or certified practitioners of law and medicine, medical interns and residents covered under this exemption, the salary basis and salary requirements do NOT apply.

Learned Professional

Primary duty consists of the performance of work that requires advanced knowledge (beyond high school) and that is predominantly intellectual in character and consistently includes the exercise of discretion and independent judgment.

The advanced knowledge is in a field of science or learning.

The advanced knowledge was acquired by a prolonged course of specialized intellectual instruction (position possesses the appropriate academic degree or has substantially the same knowledge level and performs substantially the same work as degreed employees but possesses advanced knowledge only through a combination of work experience and intellectual instruction).

Creative Professional

Primary duty consists of the performance of work requiring invention, imagination, originality or talent in a recognized field of artistic or creative endeavor as opposed to routine mental, manual, mechanical or physical work.

To link to the DOL Professional Exemption information, click here.

COMPUTER-RELATED (examples: network or database analyst, developer, programmer, software engineer)

Is paid at least $23,660 annually ($455 weekly) OR $27.63 per hour. That is, this exemption does NOT have to meet the salary basis requirement to regularly receive a predetermined amount constituting all or part of the employees salary, which is not subject to reduction because of variations in the quality or quantity of work performed IF paid at least $27.63 on an hourly basis.)

Primary duty consists of:

    The application of system-analyst techniques and procedures, including consulting with users to determine hardware, software or systems functional specifications, OR

    The design, development, documentation, analysis, creation, testing or modification of computer systems or programs, OR

    The design, documentation, testing, creation or modification of computer programs related to machine-operating systems, OR

    A combination of these duties which requires the same level of skills.

To link to the DOL Computer-Related Exemption information, click here.

OUTSIDE SALES (examples: salespersons, contract negotiators)

The salary basis and salary requirements do NOT apply for this exemption. That is, this exemption does NOT have the salary basis requirement to regularly receive a predetermined amount constituting all or part of the employees salary, which is not subject to reduction because of variations in the quality or quantity of work performed, AND this exemption does NOT have to be paid $23,660 annually ($455 weekly).

Primary duty consists of making sales or obtaining orders for contracts for services or for the use of facilities for which consideration will be paid by the client or customer.

Customarily and regularly is engaged away from the employers place or places of business.

To link to the DOL Outside Sales Exemption information, click here.

HIGHLY COMPENSATED EMPLOYEES PERFORMING EXECUTIVE,

PROFESSIONAL OR ADMINISTRATIVE DUTIES

Is paid an annual total compensation of $100,000 or more, which includes at least $455 per week paid on a salary basis. The required total annual compensation of $100,000 or more may consist of commissions, nondiscretionary bonuses and other nondiscretionary compensation earned during a 52-week period, but does not include credit for board or lodging, payments for medical or life insurance, or contributions to retirement plans or other fringe benefits.

Primary duty consists of performing office, nonmanual work. Note: No matter how highly paid, manual workers or other blue-collar workers, including nonmanagement construction workers, who perform work involving repetitive operations with their hands, physical skill and energy are not eligible for this exemption.

Customarily and regularly performs at least one of the exempt duties or responsibilities of the Executive, Professional or Administrative Exemption.

To link to the DOL Highly Compensated Exemption information, click here.

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