HomeMy WebLinkAboutFD-22.5 - Leave Payoff Request
__________________ ______________ ____________________________________
FD-22.5
FRESNO CITY FIRE DEPARTMENT
LEAVE PAYOFF REQUEST
LEAVE PAYOFFS CODES
Annual Leave LV3
Comp Time Y03
Employee Incentive Time EINT
Holiday Time (Units 1, 2, 3, 13, 14) H02
Holiday Time (Units 5 and 10) H12
Management Leave (Units 2, 13, 14) M02
Management Leave (Unit 10) MP5
Vacation Time V03
I, ____________________________________________________, hearby request payment of my
________________ leave balance to be paid on the ______________________________ payday.
The number of hours of leave to be paid ____________ hours.
Division No. Employee ID Signature
Note: Fire Payroll must receive this request at least five (5) business days before the requested payday.
PAYROLL SECTION USE ONLY
Leave hours x hourly rate (leave payoff code ) = $
Pay Period Posted
Completed By
FD-22.5 (11/24/21)