Fair Labor Standards Act $($FLSA$)$ Designation Worksheet $(5$ CFR Part $551)$

$($Complete Worksheet in conjunction with Instructions for Completing the FLSA Designation Worksheet$)$

Position Title$/$Pay Plan$/$Series$/$Grade: Position Number$/$Organization$/$Organization Code:

I.Foreign Exemption $(\S 551\mathrm{.}212)$ and$/$or Exemption of employees receiving availability pay $(\S 551\mathrm{.}213)$

If any of the boxes in this section are marked, the employee$/$position is Exempt and the remaining sections need not beapplied. See $\S 551\mathrm{.}104$ for definition of Exempt Area. Refer to $\S 551\mathrm{.}212$ when administering employees$/$positions meetingthe criteria for foreign exemption.

$☐$

The employee is permanently stationed in an exempt area and spends all hours of work in a given workweek in one or more exempt areas$($foreign exemption$)$

$☐$

The employee is not permanently stationed in an exempt area, but spends all hours of work in a given workweek in one or more exempt areas $($foreign exemption$)$

$☐$

Criminal investigator receiving availability pay under $\S 550\mathrm{.}181($a$),$ as provided in $29$ U$.$S$.$C$.213($a$)(16)$

$☐$

Pilot employed by U$.$S$.$ Customs and Border Protection or its successor who is a law enforcement officer as explained in $\S 551\mathrm{.}213($b$)$

II$.$Salary based Nonexemption $(\S 551\mathrm{.}203)$ and$/$or Nonexemption of certain employees $(\S 551\mathrm{.}204)$If any of the boxes in this section are marked, the employee$/$position is Nonexempt if: $1)$ none of the boxes in Section I are

checked; and $2)\S 551\mathrm{.}208($c$)$ Practice of law, $\S 551\mathrm{.}208($d$)$ Practice of medicine, or $\S 551\mathrm{.}208($h$)$ Teachers, do not apply tothe employee$/$position$.$

$☐$

Annual rate of basic pay is less than $$23,660$

$☐$

Equipment operating or protective occupations $($nonsupervisory$)$

$☐$

Clerical occupations $($nonsupervisory$)$

$☐$

Technician work below GS$-09$ and many, but not all, of those positions that are at or above GS$-09($nonsupervisory$)$

$☐$

Nonsupervisory employees in the Federal Wage System $($or comparable systems$)$

$☐$

Employee$/$position requires highly specialized, technical skills and knowledge that can only be acquired through prolonged job trainingand experience, such as Air Traffic Control or Aircraft Operation $($applies to nonsupervisory white$-$collar employees$).$