Meal Period and Rest Break Employee Certification

Summary

This template is a meal period and rest break employee verification or certification that an employer may use to obtain an employee's signed acknowledgement documenting compliance with applicable meal period and rest break requirements. This template includes practical guidance and drafting notes. This template is intended for private employers. It is based on federal law and does not address all potential state law distinctions; thus, you should check any relevant state and local laws. Employers can use this template as a standalone certification or include the certification as part of the employee's timesheet or payroll submission for each pay period. For more information on state law requirements on meal periods and rest breaks (and lactation breaks), see Meal Period and Rest Break State Law Survey and the Compensable Time column of Wage and Hour State Practice Notes Chart or the Wage and Hour topic in the Practical Guidance Labor & Employment State Law Comparison Tool. For a non-jurisdictional rest break and meal period policy, see Meal, Rest, and Lactation Break Policy. For state-specific meal and rest break policies, see the Attendance, Leaves, and Breaks column of Employment Policies State Expert Forms and Checklists Chart.