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SEIU_Hardship_Leave_Donation_Form_-_11-18

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SEIU Hardship Leave Donation In accordance with Article 36, Section 8, of the SEIU Collective Bargaining Agreement, classified employees may voluntarily donate accrued vacation leave and/or compensatory time for use by another classified employee who has exhausted all forms of accumulated leave and continues to experience time off due to a temporary serious medical condition At this time, we have a classified employee who qualifies for Hardship Leave and has asked to participate in the program If you would like to assist a co-worker at a time of need, please complete this form and return to Human Resource Services at your earliest convenience I, (print name) _ agree to donate hours of my accumulated vacation leave and hours of my accumulated compensatory time to the following named employee, (print name of employee receiving leave) _ I understand that such leave becomes available to donee exclusively and any unused balances are not recoverable Employee’s Signature: Date: The Payroll/Benefits Office will provide you with a copy of this document that includes your leave balances after your donation Thank you in advance for this act of generosity Vacation leave balance after transfer: Compensatory time balance after transfer: HRS 01/20

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