INFORMATION Please Read Before Completing This Form

INFORMATION Please Read Before Completing This Form

/ APPLICation for
cash payment of
Excess ANNUAL
Leave
(HR/cAl)
effective 08/14
Office use only:
Actioned / Initials / Date
School/DivisionBusiness
Manager / //20
Faculty/Portfolio Business
Manager / //20
Payroll Services / //20
Offline Pay Created / //20

INFORMATION— please read before completing this form

1Cash-out ofannual recreation leave (AL) is only available to staff members with abalance of 25days (working days) or more (pro rata for part-time staff)at the time of application.A staff member’s AL balance may not fall below 20 days (pro-rata for part-time staff) as a result of any application.

2The minimum period able to be cashed-outisfive (5)days and each request may only be in multiples of 5 days.

3Approval of applications for an AL cash-out is subject to the University’s operational requirements and the University has no obligation to grant the application.

4Each application will be considered on its merits by the relevant approver and have regard to the staff member’spast and future leave bookings, the possible health and safety effects of foregoing a period of ALand whether a cash-out is in the best interests of the staff member and the area.

5Completed applications should be forwarded, through the School/Division and Faculty/Portfolio BusinessManagers, to Payroll Services, forprocessing in the next available pay.

6The fullAL provisions are available at:Annual Recreation Leave - Flinders University

7To complete this form electronically, simply tab from cell to cell.

SECTION 1— EMPLOYEE DETAILS

Family Name: / Given Name(s): / Payroll Number:
Faculty/Portfolio: / School/ Division:
Email Address: / Contact Telephone Number:

SECTION 2— DETAILS OF CASH PAYMENT REQUESTED

Amount of AL to be converted to a cash payment (multiples of 5 days) / Days
Any comments:

SECTION 3 — EMPLOYEE DECLARATION

I declare that my application for cash out of AL will not cause my ALbalance to fall below 20 days (pro rata part-time) and Iacknowledge that:
  • the portion of AL cashed out will attract employer superannuation contributions and will be taxed at my marginal rate
  • the cash payment will be included in the gross earnings on my Payment Summary for the financial year in which it is paid
  • no leave entitlements will be earned on this cash payment

Employee Signature: / Date:
//20

SECTION 4 — APPROVALS

  • I am satisfied that the cash out of AL will not cause the employee’s AL balance to fall below 20 days (pro rata part-time), I have considered the circumstances outlined in Information Note 4 above and approve the AL cash payment to be made to the nominated employee
  • I acknowledge that the AL cash payment will attract full on-costs (including superannuation)

Supervisor Signature: / Print Name: / Date:
//20
Dean of School/Head of Division Signature: / Print Name: / Date:
//20

HR/CAL (08/14)Page 1 of 1