Fillable Usps Sick Leave Pool Request Form printable pdf download

Usps Sick Leave Pool Request Form

Download a blank fillable Usps Sick Leave Pool Request Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Usps Sick Leave Pool Request Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

USPS SICK LEAVE POOL REQUEST FORM

Instructions: This form must be submitted to Human Resources with a completed UCF Medical

Certification Form.

Name_______________________________________________________________________________

(Last)

(First)

Position Title: __________________________________

Department__________________________

Home Address________________________________________________________________________

Home Phone Number____________

Cell Phone Number___________

Empl ID___________

Reason for Request: ___________________________________________________________________

Expected Dates of Absence:

From_____________ To_________________

Expected Dates of Leave without Pay:

From_____________ To_________________

I have attached a UCF Medical Certification Form signed by my doctor. I understand that the medical

certification Form will be reviewed by the USPS Sick Leave Pool Committee for the expressed purpose of

determining eligibility for sick leave pool hours.

I understand that t

he number of hours a member can withdraw from the pool is determined by the employee’s

highest personal sick leave balance during the twelve (12) month period immediately preceding his/her request.

Beginning with the date the pool is first used, an employee will be eligible to use one day from the pool for each

day of personal sick leave accrual up to a maximum of 480 hours. An employee whose highest sick leave balance

is less than 120 hours shall be able to use a maximum of 120 hours from the pool.

If I am granted hours from the USPS Sick Leave Pool, it is my understanding that I must return unused hours to

the USPS pool. I must notify Human Resources of the hours that I will be returning to the pool. I also understand

that I must use all accrued overtime comp., annual, and sick leave hours before using sick leave pool hours. A

copy of my Leave and Pay Exception Report must be forwarded to Human Resources each pay period sick leave

pool hours are used. Should I use all of the hours granted to me from the pool, I understand that my membership

will automatically terminate. To re-enroll in the sick leave pool I am subject to the initial enrollment

requirements for membership.

Employee Signature_________________________________________________________Date______________

Supervisor’s Signature_______________________________________________________Date______________

Usps Sick Leave Pool Request Form

Related Articles

Related forms

Related Categories