SEIU/OPEU Request Form
Pursuant to Article 47, Section 17, of the Collective Bargaining Agreement between the Oregon University System and the SEIU Local 503, Oregon Public Employees Union, I hereby request to cash out ____ hours of vacation leave (not to exceed 40 hours). I understand that the following provisions apply:
- I must have at least eighty (80) hours of accrued vacation leave remaining after the cash out;
- This request can only be made once in each twelve month period and must be made in January;
- Payment is subject to deductions and withholdings;
- This request is irrevocable. Once cashed out, I will not be able to buy back hours at a later time;
- Requests received prior to January payroll cutoff will be paid with January pay;
- Requests received after January payroll cutoff will be paid with February pay.
| Employee's UO ID # | |
| Department | |
| Employee's Signature | |
| Dean/Director/Dept Head Signature |
| FOR DEPARTMENT/COLLEGE USE ONLY | |
|---|---|
| Vacation balance before cash-out | |
| Hours cashed out | |
| Balance after cash out If less than 80, request must be denied |
|
| Approval Status | |
| Account Code | 10411 |
| Amount | |
| Authorized Signature | |
PROCEDURE: (1) Employee/department complete form and submit to departmental payroll staff. (2) Departmental/unit timekeeper uses Banner form PHAHOUR with LPV earn code during January time entry.