At Architecture North Ltd, employees are encouraged to take their full designated breaks to ensure wellbeing and productivity.

Working through breaks is discouraged and should only be done in exceptional circumstances.

If you choose to forgo your break, this form allows you to record the time as accrued Time off in Lieu.

Please note that Time off in Lieu must be approved by your line manager and used in accordance with company policies.

Name of Employee

Employee Company Number

EMPXXAN

Employee Personal Phone Number

Employee Personal Email Address

Employees Job Title

Date of Form Submission

Employee Line Manager

Name of Line Manager Undertaking this Form

Line Manager's Job Title

Date(s) Break Was Not Taken

Reason for Not Taking Break

Duration of Break Forgone (per day)

Total Time Accrued as Time Off in Lieu

Proposed Date(s) to Use Accrued TOIL

Employee Declaration

I, the Employee, confirm that I voluntarily worked through my break and understand this is not encouraged as a routine practice.

Any Additional Comments

If Not Applicable, please enter N/A in this text box.

Line Manager's Details

Line Manager's Name

Line Manager's Email Address

Line Manager's Phone Number

Line Manager's Company Number

EMPXXAN

Digitally Typed Signature

Do you agree that your typed full name signature replaces, in this context, your written signature.

Yes, I agree

Line Manager's Password

First & Last Name Initial followed by the Day, Month, then Year of Your Birth

Date of Declaration

Time of Submission (Digital Format)

Do you confirm that all the information you have provided Today is Correct

Yes, Declaration Made

Would you like to provide any Additional Information?

If Not Applicable, please enter N/A

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