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Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35
 |  |  |  |  |  |  |  | City and County of Denver
 |  |  |  |  |  |  |  | Request to Donate Sick/PTO Leave
 |  |  |  | Instructions
 |  |  |  |  |  | In order to donate sick or PTO leave, you must have:      - A minimum of 240 sick hours after the donation (CBA employees must have minimum balance remaining per CBA)      - Been earning sick leave from the City continuously for the past five years OR      - A minimum of 80 PTO hours after the donation Once a donation has been applied to the recipient’s bank, the donation cannot be returned. The recipient may not accept more hours than originally requested. If the hours that you request to donate are greater, the difference will be remain in your sick or PTO leave bank. To donate sick or PTO , please complete all fields on the top half on this form. Once completed, you may either:      - Save this form, attach to an email and send to [EMAIL]      - Print, sign and then interoffice the Controller's Office, Payroll Division
 |  |  |  |  |  | Please refer to CS Rule 10-45 for additional information and disclosure.
 |  |  |  | Donor Information
 |  |  |  |  |  |  | Donor Name |  |  |  |  |  |  |  |  | Donor ID Number |  |  |  |  |  |  | Donor's Department/Agency
 |  |  |  | Recipient Information
 |  |  |  |  |  |  | Recipient Name |  |  |  |  |  |  |  |  | Recipient ID Number |  |  |  |  |  |  | Recipient's Department/Agency
 |  |  |  | Request
 |  |  |  |  |  |  | I, | Your Name |  |  |  |  |  |  |  |  |  |  |  | , | would like to donate |  |  |  |  | # |  | hours of sick/PTO to
 |  |  |  |  |  |  | Recipient Name |  |  |  |  |  |  |  |  |  |  |  | .
 |  |  |  |  |  | I understand that I must have a minimum of 240 sick hours after the donation and that I have been earning this sick leave from the City continuously for the last five years. For PTO I must have a minimum 80 after the donation. Once donations are applied to the recipient's bank, the donation cannot be returned. Please read CS Rule 10-45 for disclosure
 |  |  |  |  |  |  | Donor Signature |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date
 |  |  |  |  |  |  | *By saving and emailing this form, I am authorizing my electronic signature.
 |  |  |  | For Controller's Office, Payroll Division use only
 |  |  |  | Donor's Leave Accrual Date: |  |  |  |  |  |  |  |  | [NAME]/dd/yyyy |  |  |  | Total Sick/PTO Hours prior to donation: |  |  |  |  |  |  |  |  |  |  |  |  |  | Date Received: |  |  |  | [NAME]/dd/yyyy
 |  |  |  |  | Recipient has been approved to receive donated sick/PTO |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | After Donation: |  |  |  |  |  |  |  |  | Date Applied to Bank: |  |  |  | [NAME]/dd/yyy
 |  |  |  | Donor Agency Computation:
 |  |  |  | # |  |  |  |  |  |  |  |  |  |  | x |  |  |  |  |  |  |  |  |  |  |  | = | 0
 |  |  |  | Number of Hours |  |  |  |  |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  | (a)
 |  |  |  | Recipient Agency Computation:
 |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | =
 |  |  |  | (a) |  |  |  |  |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  | (b)
 |  |  |  | Sick/PTO leave hours credited to Recipient:
 |  |  |  | Above rounded down to closed full hour:
 |  |  |  | *CBA have a different rule regarding rounding. Please see current CBA