Lump Sum Worksheet Vacation Budget Template
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LUMP SUM WORKSHEET
NAME:__________________________
SEPARATION DATE:__________________________________
SSN:____________________________
TYPE OF SEPARATION:_______________________________
POSN NO.:_______________________
TENURE:____________
TIME BASE:_______________
VACATION GROUP CODE:_________
VACATION HOURS PER MONTH:_______________________
1. Obtain the most current leave balance printouts and attendance history (for full calendar year) from CLAS. Attach
printouts to worksheet.
2. Verify all leave credits and clear any discrepancies with appropriate attendance clerk.
3. TOTAL VACATION AT TIME OF SEPARATION:
_______________HOURS
4. ADDITIONAL QUALIFIYING PAY PERIODS
___________ MONTH(S) @ _________ HOURS
_______________HOURS
PERSONAL LEAVE (PLP)
_______________HOURS
TOTAL VACATION & PERSONAL LEAVE:
_______________HOURS
ENTER THIS BALANCE ON PAR, ITEM 620, VACATION & PLP
TOTAL (A)
5. ADDITIONAL LEAVE CREDITS:
PERSONAL HOLIDAY:
_______________HOURS
HOLIDAYS: (skipped)
_______________HOURS
CTO:
_______________HOURS
EXCESS HOURS:
_______________HOURS
HOLIDAY CREDIT:
_______________HOURS
TOTAL ADDITION LEAVE
_______________HOURS
ENTER THIS BALANCE ON PAR, ITEM 625, EXTRA HOURS
TOTAL (B)
6. TOTAL (ADD A+B):
_______________HOURS
7. TOTAL DAYS:________________
_______________HOURS
8. LSV THRU DATE:_____________
_______________HOURS
_____________________________________
__________________________________
PREPARED BY SIGNATURE AND DATE
REVIEWED BY SIGNATURE AND DATE
REMARKS:
__________________________________________________________________________________________
__________________________________________________________________________________________
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