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Sample Policy -
Vacation/Sick Leave Donation Policies:
PURPOSE: To establish a procedure through which eligible
employees may voluntarily donate a portion of their accrued vacation/sick leave
balance to be converted to cash to financially assist another employee who has
exhausted sick leave, vacation, and holiday hours due to his/her extended
illness or disability.
POLICY: All full-time or regular part-time employees who
have completed the probation period will be considered eligible to participate
in this program.
PROCEDURES:
- Donations of accrued vacation/sick leave must be in whole hours, with a
minimum of one hour per donation, a separate form must be completed for each
pay period in which a donation is desired.
- The donating employee shall specify the employee to receive the value of
the donation.
- Prior to proceeding the first donation(s) to an employee, the City will
verify the eligibility of the named recipient (i.e. employee status and
exhaustion of paid sick leave) and request the individual's written consent to
receive donations. No donations will be processed until this written
authorization is received. The authorization will remain valid until the
individual revokes it or he/she becomes ineligible to participate in the
program.
- The donated vacation/sick leave will be converted to dollars by the City
by multiplying the number of hours donated by the donor's hourly base pay rate
at the time of processing The resulting amount, less mandatory
withholding (specified below), will be paid to the designated recipient.
- Under a similar program, the IRS has ruled that these payments are to be
considered wages, and therefore taxable income to the recipient. As a
result, the payments will be included in the annual Form W-2 prepared for the
recipient and State and Federal income tax and FICA/Medicare tax and
Supplemental Retirement contributions depending on the eligibility of the
recipient, will be withheld by the City at the time of payment. The IRS
has also ruled that the donating employee realizes no income and incurs no tax
deductible expense or loss, either upon donation or payment to the recipient.
- The City will not inform the recipient of the names of those donating
hours or the number of hours donated.
- The donations processed for a recipient each pay period shall be limited
to the amount equal to that individual's regular gross earnings per pay period
(i.e. his/her current hourly base rate multiplied by his/her schedule hours of
work per pay period). In the event donations exceed this limit, they
will be processed in order of the date on the donation authorization form,
with the earliest date processed first. Excess donations will be held
until the following pay period(s) and processed at that time.
- Once a donation has been processed, neither the donor nor the recipient
may revoke the transaction, even if it has not yet been paid.
- Program information maintained by the City shall be handled in accordance
with the Government Data Practices Act, M.S. 13.43., subd. 2.
ADMINISTRATIVE RESPONSIBILITY: The Clerk-Treasurer shall
be responsible for implementing and maintaining this program.
CITY OF _____________
VACATION/SICK LEAVE DONATION PROGRAM
Vacation/Sick Leave Waiver & Donation Authorization Form
Having read and understood the City of ______________
Vacation/Sick Leave Donation Program on the back of this form, and subject to
the terms and conditions set forth therein, I hereby voluntarily waive my
entitlement to and donate __________ hour(s) of my accrued vacation, ___________
hour(s) of my accrued sick leave on the condition that the equivalent dollar
value of the hour(s) I donate is paid by the City of ___________ to the employee
I have identified below:
EMPLOYEE TO RECEIVE DONATION:
Print name: ___________________________________ Department:
__________________________
(Last)
(First)
I understand that, upon submission of this form, I cannot
control the timing of the deduction of the donated hour(s) from my vacation/sick
leave balance and that, while I will not be specifically notified when the
donation is processed, I may determine this by monitoring the vacation/sick
leave balance reported to the City Council and department heads monthly.
Donor's Name (print): _______________________________________
(Last)
(First)
Donor's Social Security Number: _______________________________
Donor's Department Name: ___________________________________
Donor's Work Phone Number: ________________________________
Donor's Signature: _____________________________________________ Date:
____________________
Return form to: ____________________
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