FLSA Exemption Test Form

FLSA Exemption Test Form

PROFESSIONAL

Learned professional: Primary duty is the performance of work requiring knowledge of an advanced type including the consistent exercise of discretion and judgment in a field of science or learning where the advanced knowledge is acquired by a prolonged course of specialized intellectual instruction.
Creative professional: Primary duty involves the performance of work requiring invention, imagination, originality or talent in a recognized field of artistic or creative endeavor.
Job Class:Click here to enter text. / Class Code:Click here to enter text.
Working Title:Click here to enter text. / Agency:Choose an item.
1. /

Is a prolonged course of specialized intellectual study in a field of science or learningrequired for this position?

Fields of science or learning: include law, medicine, theology, accounting, actuarial computation, engineering, architecture, teaching, various types of physical, chemical and biological sciences, pharmacy and other occupations that have a recognized professional status and are distinguishable from the mechanical arts or skilled trades.
Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
2. /

What is the incumbent’s primary duty?

Primary Duty: The principal, main, major, or most important duty that the incumbent performs. (May be found in “position purpose,” if listed on position description. Otherwise, look to responsibility assigned highest priority / percentage of time.)
Response: Click here to enter text.
3. /

Does the incumbent’s primary duty require the advanced knowledge / prolonged intellectual study as described in Question 1?

Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
4. /

What percent of the incumbent’s job duties require the degree / intellectual study referenced in Question 1 in order to be performed?

Select one:Choose an item.
5. /

What other type of duties (that may not require the degree) does the incumbent perform?

Response:Click here to enter text.
6. /

Does the incumbent’s primary duty require the consistent exercise of discretion and judgement?

Note: Discretion and judgment does NOT include:

• Following prescribed procedures or determining which procedures to follow;
• Determining whether specified standards have been satisfied;
• Performing inspection functions by following established techniques and procedures;
• Formulating recommendations based upon the development of facts concerning conformity with a known standard;
• Comparing items based upon established standards;
• Screening applicants/conducting interviews to determine satisfaction of minimum qualifications; or
• Making decisions that do not commit the employer in substantial respects.

Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
7. / For the Creative Professional only:Does the incumbent’s primary duty involve the performance of work requiring invention, imagination, originality, or talent in a recognized field of artistic or creative endeavor? For example…
Does the position require creative or original analysis and interpretation?
Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
Does the individual have broad leeway to develop an original work product?
Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
Does the incumbent have the latitude to control their final work product?
Check One:
YES ☐ NO ☐ / Notes:Click here to enter text.
8. / For Mixed Classes Only: What criteria does the agency rely upon when making the FLSA designation decision at the position level?
Response:Click here to enter text.
Is there a similar non-exempt position in State that does not require a degree?
Check One:
YES ☐ NO ☐ / Notes: Click here to enter text.
Other Considerations: Click here to enter text.
Final Determination: Does this position meet the Professional Exemption Duties test?
Check One: YES ☐ NO ☐ / Notes: Click here to enter text.