New York City Public Schools PER SESSION UNUSED SICK …

[Pages:1]New York City Public Schools

PER SESSION UNUSED SICK TIME TRANSFER FORM

* * * * * FOR PER SESSION YEAR ENDING AUGUST 31, 20

* * * * *

This form is to be utilized to transfer accrued Per Session sick leave to the employee's regular cumulative absence reserve.

EMPLOYEE INFORMATION LAST NAME:

SS# OR FILE NUMBER:

BUDGET CODE/GRANT NUMBER:

PER SESSION INFORMATION

DISTRICT:

SCHOOL:

FIRST NAME: LINE NUMBER: PROGRAM NAME:

UNUSED SICK TIME ACCRUED

HOURS

MINUTES

This certifies that the statements made above are accurate and correct.

PRINT NAME PRINT NAME PRINT NAME

DHR'OP 1755-5191

SIGNATURE OF EMPLOYEE

Date

PER SESSION PAYROLL SECRETARY

Date

PER SESSION SUPERVISOR

Date

VToro Rev 3/2007

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download