2015 CARRYOVER VACATION &/OR COMP TIME REQUEST

Electronic signatures are permissible – Please make a copy for your records

Complete this form if you wish to carry over to 2016 any amount of unused 2015 Comp Time or unused 2015 Vacation in excess of 40 hours. Forward this form to your supervisor by Monday, November 23, 2015. Your supervisor will review and approve or deny the request and if approved, forward to the department head by Monday, November 30, 2015. The department head will then forward to Payroll by Friday, December 4, 2015. Supervisors who serve as Department Heads must sign as both Supervisor and Department Head.

NOTE: If you fail to complete and return this form to your supervisor in time, the assumption will be that you elected to use your vacation and/or comp time leave prior to December 31, 2015.

Employee Name:

Vacation Carryover

EMPLOYEE
I request to carry over hour(s) of 2015 Vacation into 2016 in excess of the 40 hours allowed. I understand that carryover Vacation hours must be used by June 30 of the following year and I intend to use it by . I am requesting this carryover for the following reason(s):
Employee’s Signature / Date
MANAGEMENT – Please complete this section for VACATION CARRYOVER only! Comp Time section is below
Supervisor: / Date: / Approved Denied for Reason Below
Dept. Head: / Date: / Approved Denied for Reason Below
Denial Reason:

Comp Time Carryover

EMPLOYEE
I request to carry over hour(s) of 2015 Comp Time into 2016. I understand that carryover comp time hours must be used by December 31 of the following year and I intend to use it by . I am requesting this carryover for the following reason(s):
Employee’s Signature / Date
MANAGEMENT – Please complete this section for COMP TIME CARRYOVER only! Vacation section is above
Supervisor: / Date: / Approved Denied for Reason Below
Dept. Head: / Date: / Approved Denied for Reason Below
Denial Reason:

SUPERVISOR: Submit Approval or Denial to CEO by Monday, November 30, 2015

DEPARTMENT HEAD: Submit Approval or Denial to Payroll by Friday, December 4, 2015