Employee’s Name: _________________________ TWU ID # ___________________
Department: ________________________ Position Title: _________________________
An employee may transfer one or more days to the Sick Leave Pool. The pool administrator shall credit the Sick Leave Pool with the amount of time contributed by that employee and shall deduct that amount of time from the total the employee has accumulated as if the employee had used the time for personal sick leave purposes.
A terminating employee may elect to contribute his or her sick leave balance to the pool but should carefully consider this decision if there is a possibility of being employed by the state within twelve months and thereby eligible to have the sick leave balance restored. Any terminating employee who contributes sick leave to the pool is not eligible to have those hours restored if he or she returns to state employment within twelve months.
A retiring employee may designate the number of the retiring employee’s accrued sick leave hours to be used for TRS retirement credit and the number of the retiring employee’s accrued sick leave hours to be donated on retirement to the Sick Leave Pool.
Employees may not stipulate how or who will receive their Sick Leave Pool contributions.
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Donation from Active Employee Only |
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I wish to contribute _________ (number) hours of sick leave to the Sick Leave Pool.
________________________________ _________________________ Employee Signature Date |
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Donation from Employee Separating from Service |
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I wish to contribute:
□ the entire balance of my sick leave, or □ _________ (number) hours of sick leave.
________________________________ ___________________________ Employee Signature Date |
Forward this form to Human Resources.
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Human Resources/Payroll Processing |
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Credit to Sick Leave Pool ___________ (hours) on _____________ (date) by ________ (HR).
Debit _________ (hours) to Sick Leave Records on ________ (date) by__________ (Payroll).
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