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REQUEST FOR ADVANCE VACATION PAY

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					REQUEST FOR ADVANCE VACATION PAY AND CONVERSION OF VACATION LEAVE TO PAYMENT

Date: To: Payroll Department From: Employee #:

REQUEST FOR ADVANCE VACATION PAY: I request advanced pay for my vacation.

Date vacation starts:

Date employee will depart:

Date employee will return to work:

Paycheck date requested for advance payout: ___________________ Vacation time that will be used: Hours (Must be in increments of 40 hours.)

(NOTE: Full amount of bi-weekly deductions will be taken out of this check)

CONVERSION OF VACATION LEAVE TO PAYMENT: I request to convert hours (40 hours or if employed over 9 years may elect

80 hours) of accrued vacation to payment. Dates of vacation leave this fiscal year: (For cash payment, must have taken a minimum of 40 hours of vacation leave during this fiscal year or 80 hours of vacation leave if requesting 80 hours.)

Please note that all requests for advance vacation pay must be turned into payroll at least two (2) weeks before vacation starts.

Employee Signature: Dept. Head Approval:

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