How to Fill Out an FLSA Exemption Form: Salary, Duties, and Safe Harbor

An FLSA exemption worksheet is an internal document you build to decide whether a specific position is exempt from the Fair Labor Standards Act’s minimum wage and overtime rules. There is no official Department of Labor form. You create your own using 29 CFR Part 541 and the DOL’s Fact Sheets, and you walk the position through three checks in order: salary level, salary basis, and the duties test for whichever exemption category fits. The completed worksheet is the employer’s written justification for withholding overtime from that role, so it needs to reflect what the employee actually does — not what the job posting says.

What Goes at the Top

Before filling anything in, gather a current job description that matches the employee’s day-to-day work, the employee’s real schedule (including how hours fluctuate), and recent payroll records showing base pay, bonuses, and commissions. A three-year-old job description will not carry the analysis.

The header ties the analysis to one person and one point in time. Record the employee’s full name, employee ID, department, supervisor, hire date, and current compensation. Assign a date to the analysis itself; if the DOL later audits, you may need to show when the classification decision was made. If you are evaluating several positions, keep the format identical across worksheets so comparisons and audits are manageable.

Step 1: The Salary Level Test

The salary level test is the first gate. Under 29 CFR § 541.600, most white-collar exemptions require the employee to earn at least $684 per week, or $35,568 per year.¹ If the employee earns less, stop. The position is non-exempt regardless of duties, and overtime applies.

The DOL tried to raise this threshold in 2024, first to $844 per week effective July 1, 2024, then to $1,128 per week effective January 1, 2025. On November 15, 2024, the U.S. District Court for the Eastern District of Texas vacated the entire rule. The enforceable salary level reverted to $684 per week, and that is the figure the DOL applies for enforcement purposes as of 2026.² Your worksheet uses $684 unless a new rule takes effect.

Nondiscretionary bonuses and incentive payments, including commissions, can count toward up to 10 percent of the standard salary level if paid at least annually.¹ Several states set higher salary floors — Washington, California, New York, and Colorado among them, in some cases nearly double the federal number. If the employee works in one of those states, the state figure controls, and the worksheet needs to show the state comparison, not just the federal test.

Step 2: The Salary Basis Test

Passing the salary level does not end the pay analysis. Under 29 CFR § 541.602, the employee must be paid on a salary basis: a fixed, predetermined amount each pay period that does not vary based on how much or how well they work.³ An exempt employee who does any work in a given week must receive their full salary for that week, even after a two-day workweek.⁴ A week with zero work is not owed.

Docking pay because the employee left early on a Wednesday or turned in mediocre work is the kind of deduction that can destroy the exemption, and not just for that employee — potentially for every employee in the same job classification. On the worksheet, record whether the employer has ever reduced this employee’s pay for partial-day absences or quality-of-work reasons. A “yes” is a problem to fix before the classification can stand.

The Safe Harbor for Improper Deductions

29 CFR § 541.603 provides a safety net. An employer that makes an improper deduction keeps the exemption if it has a clearly communicated written policy prohibiting such deductions, a complaint mechanism for employees, reimbursement of the affected employee, and a good-faith commitment to future compliance.⁵ The best evidence is a written policy distributed at hire or published in the handbook. Continuing to make improper deductions after receiving complaints kills the safe harbor. Flag on the worksheet whether the organization has this policy; its absence is a risk worth noting.

Step 3: The Duties Test

Clearing the pay tests only gets you to the duties analysis, and this is where most classifications succeed or fail. The regulation looks at the employee’s primary duty — the principal or most important function they perform. Job titles do not count. A “Director of Operations” who spends the day running a register is not exempt.

The worksheet must describe what the employee actually does, based on observation and interviews, not what the job description promises. Pick the exemption category that fits the role and walk through its specific prongs.

Executive

Under 29 CFR § 541.100, the executive exemption has three prongs beyond the salary tests. The employee’s primary duty must be managing the business or a recognized department. They must regularly direct the work of at least two full-time employees, or the equivalent — four half-time employees count. And they must have genuine authority to hire or fire, or their recommendations on those decisions must carry real weight.⁶

A shift leader who occasionally assigns tasks but has no say in hiring, firing, or scheduling does not qualify. Document who is being supervised, the nature of that supervision, and evidence that the person’s input on personnel decisions actually matters to higher management.

Administrative

Under 29 CFR § 541.200, the administrative exemption covers employees whose primary duty is office or non-manual work directly related to management or general business operations, and who exercise discretion and independent judgment on matters of significance.⁷ Both prongs must hold.

Discretion and independent judgment does not mean choosing which task to do first. It means the employee can formulate or interpret company policies, commit the employer to significant financial decisions, or deviate from established procedures without prior approval. An accounts-payable clerk working from a fixed checklist is not exercising that kind of judgment, however skilled the work.

The other common trap is the line between administrative work and production work. Administrative work supports the running of the business — HR, finance, marketing strategy, legal compliance. Production work creates what the business sells. A recruiter at a staffing agency is doing production work, because placing candidates is the product. A recruiter at a manufacturing firm is more likely administrative, because recruiting supports the business rather than being its output. On the worksheet, identify the employer’s primary product or service, then evaluate on which side of that line the employee’s work sits.

Professional

Under 29 CFR § 541.300, the learned professional exemption applies when the primary duty requires advanced knowledge in a field of science or learning, that knowledge came from a prolonged course of specialized instruction, and the work is predominantly intellectual and requires consistent independent judgment.⁸ Lawyers, doctors, engineers, and architects are the textbook cases. The field must require specialized academic training — not just experience or a general degree.

Creative professionals qualify through a separate track when the primary duty involves invention, imagination, or original thought in a recognized artistic field. Journalists, musicians, graphic designers, and actors can fall here when the work genuinely requires creative input. A reporter rewriting press releases is not doing creative professional work; an investigative journalist developing original stories likely is.

Teachers get a carve-out worth flagging on the worksheet. If the primary duty is teaching, tutoring, or lecturing at an educational institution, neither the salary level test nor the salary basis test applies — the exemption turns on the teaching duty itself.⁹

Computer Employee

Under 29 CFR § 541.400, systems analysts, programmers, software engineers, and similar roles can qualify if the primary duty involves systems analysis, software design and development, or creating and modifying programs based on user or system specifications.¹⁰ The exemption does not cover employees who primarily operate computers, troubleshoot hardware, or staff a help desk.

Computer employees have a unique option: they can qualify on an hourly basis rather than a salary basis, if they earn at least $27.63 per hour.¹¹ Note on the worksheet whether the employee is paid salary or hourly, and confirm the applicable minimum.

Outside Sales

Outside sales under 29 CFR § 541.500 has no salary requirement.¹² The primary duty must be making sales or obtaining orders and contracts, and the employee must regularly perform that work away from the employer’s place of business. Review travel logs, client meeting records, and CRM data to confirm the employee spends the bulk of working time in the field. An inside sales rep who occasionally visits a client does not qualify.

Workers You Cannot Classify as Exempt

Some workers are barred from white-collar exempt status regardless of pay. Under 29 CFR § 541.3, manual laborers and blue-collar workers who perform repetitive physical work — production-line employees, construction workers, carpenters, electricians, mechanics, plumbers — are always entitled to overtime.¹³

The same regulation excludes first responders: police officers, firefighters, paramedics, EMTs, correctional officers, park rangers, and similar employees regardless of rank or pay. A fire captain earning six figures is still non-exempt under the white-collar rules. Separate overtime provisions under Section 7(k) of the FLSA allow public agencies to use alternative work periods for these employees, but the Part 541 exemptions do not apply. If any of these roles appear on your worksheet, mark them non-exempt and stop the analysis there.

The Highly Compensated Shortcut

Higher earners have a simplified path. Under 29 CFR § 541.601, an employee who earns at least $107,432 in total annual compensation and who regularly performs at least one exempt duty from the executive, administrative, or professional categories qualifies as a highly compensated employee.² The $107,432 figure is the enforceable threshold after the 2024 rule’s vacatur; the proposed increases to $132,964 and $151,164 are not in effect.

The compensation must include at least $684 per week paid on a salary or fee basis. The rest can include commissions and nondiscretionary bonuses. If the employee falls short at year-end, the employer may make a single catch-up payment. The DOL allows this lump sum at year-end, or earlier if the employee separates.² Your worksheet should show the math: base salary plus projected bonuses and commissions, with a note about whether a make-up payment might be needed.

Mistakes That Will Void the Worksheet

Treating “salaried” as “exempt.” Paying someone a salary satisfies only one of the two required tests. An employee earning $50,000 on salary whose duties fit no exemption is non-exempt and owed overtime.
Relying on job titles. The duties test looks at actual work. A “Manager” who spends 90 percent of the day doing the same tasks as hourly staff does not qualify for the executive exemption.
Confusing administrative with clerical. The administrative exemption requires discretion and independent judgment on significant business matters. Administrative assistants, bookkeepers, and data entry staff rarely meet it, whatever the exemption is called.
Assuming all computer workers qualify. The exemption covers systems analysts, programmers, and software engineers, not everyone who uses a computer heavily. A graphic designer working in Photoshop all day does not qualify under this exemption, though they may qualify as a creative professional.
Using outdated job descriptions. A role that qualified two years ago may have drifted toward non-exempt duties. The worksheet has to reflect what the employee does now.

Signing, Storing, and Revisiting

Once the analysis is done, the person who performed it should sign and date the worksheet. A second signature from a department head or senior manager adds an internal check that someone with direct knowledge of the work reviewed the findings. This is not legally required, but it strengthens the record if the classification is challenged.

Place the completed worksheet in the employee’s personnel file. Federal recordkeeping rules under 29 CFR Part 516 require employers to preserve basic payroll records for at least three years.¹⁴ Supplementary records — wage rate tables, schedules, and documents like the exemption worksheet — must be kept for at least two years.¹⁵ Because the statute of limitations for willful overtime violations stretches to three years,¹⁶ keeping worksheets for at least three years is the safer choice.

Revisit the worksheet whenever the role changes meaningfully: a promotion, a reorganization, a shift in primary duties. A classification that was correct two years ago can become indefensible if the job has evolved and no one updated the paperwork. Misclassified employees can recover unpaid overtime plus an equal amount in liquidated damages under 29 U.S.C. § 216(b), and the DOL can add civil money penalties of up to $2,515 per violation for repeated or willful conduct.¹⁷ A thorough worksheet completed at the time of classification is the best evidence of a good-faith attempt to get it right.

1
U.S. Department of Labor. Fact Sheet 17A: Exemption for Executive, Administrative, Professional, Computer and Outside Sales Employees Under the Fair Labor Standards Act
2
U.S. Department of Labor. Fact Sheet 17H: Highly-Compensated Employees and the Part 541 Exemption Under the Fair Labor Standards Act
3
eCFR. 29 CFR 541.602 – Salary Basis
4
U.S. Department of Labor. Fact Sheet 17G: Salary Basis Requirement and the Part 541 Exemptions Under the Fair Labor Standards Act
5
eCFR. 29 CFR 541.603 – Effect of Improper Deductions From Salary
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eCFR. 29 CFR 541.100 – General Rule for Executive Employees
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eCFR. 29 CFR 541.200 – General Rule for Administrative Employees
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eCFR. 29 CFR 541.300 – General Rule for Professional Employees
9
U.S. Department of Labor. Fact Sheet: Higher Education Institutions and Overtime Pay Under the Fair Labor Standards Act
10
eCFR. 29 CFR 541.400 – General Rule for Computer Employees
11
U.S. Department of Labor. Fact Sheet 17E: Exemption for Employees in Computer-Related Occupations Under the Fair Labor Standards Act
12
eCFR. 29 CFR 541.500 – General Rule for Outside Sales Employees
13
eCFR. 29 CFR 541.3 – Scope of the Section 13(a)(1) Exemptions
14
eCFR. 29 CFR Part 516 – Records to Be Kept by Employers
15
U.S. Department of Labor. Fact Sheet 21: Recordkeeping Requirements Under the Fair Labor Standards Act
16
U.S. Department of Labor. Fair Labor Standards Act Advisor
17
eCFR. 29 CFR 578.3 – What Types of Violations May Result in a Penalty Being Assessed