ࡱ> 02/_  bjbj 4r=\r=\@rr86R`nn___$_____333_F3_333`#F300`3x x 3x 3__3_____ *___`____x _________r> : Request to Withdraw from Sick Leave or Emergency Leave Banks For Maintenance & Operations Employees Name Dept. I would like to withdraw hours from the M&O Sick or M&O Emergency Leave Banks (circle one) to cover my absence for the following reason: Expected period of absence: M&O Sick Leave Bank: I understand that I must exhaust my own accrued sick leave time and up to 50% of my vacation balance prior withdrawing from the Sick Leave Bank and that statutory disability benefits may be integrated with hours from the Bank to make up my current base weekly earnings. M&O Emergency Leave Bank: I understand that I must exhaust my own accrued sick leave time, vacation and personal time to withdraw from the M&O Emergency Leave Bank. Signed: Date: Employee Name Approved: Date: Employment Manager, Human Resources Please send your completed form to Human Resources for processing. Thank you. For HR use only: Total hours withdrawn from Bank: _______________ Date Entered: _______________      DATE \@ "M/d/yyyy" 11/19/2015 Human Resources  $'0;<=Acdfjlpqstz|}     ysi_sYi h"^aJhgTh 6aJhgThgT6aJ h aJ h}|"aJ h}|">*aJh^Qh}|">*aJ h >*aJ hGaJh^Qh}|"aJh^Qh CJOJQJaJh CJOJQJaJhgTCJOJQJaJhRCJOJQJaJhCJOJQJaJh}|"CJOJQJaJh^Qh}|"CJOJQJaJ=defq r y z D G $ $gdG p$gdG p$gdR p$gdG p$gd}|"  p$gd}|" * / 4 5 6 C p q r t w z  ' * 4 k n D G J ` ƿ帿娡勑|v h}|"aJh^QhRaJ hgTaJ hj4aJ hRaJhRhR5aJ hgT5aJ h=r5aJh h aJ h >*aJ h >*aJh^Qh}|"aJh^Qh}|">*aJ hOaJ h"^aJ h aJhgTh 6aJhgTh"^6aJ.    T U V g h gdgTgd}|" p$gd}|" $gdG p$gdG    ) 8 H S T V h o r s hgTmHnHuhpjhpUh_jh_Uh hgT6 hgT6 h 6 h-6h h 6h h+*chg%aJ hGaJ h1TaJh^Qh}|"aJ h:aJ hgTaJ h}|"aJh^Qh}|">*aJ$ 21h:p8C/ =!"#p$% s2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ }|"NormalCJPJ_HmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List `$` ugEnvelope Address!@ &+D/^@ ^J<>@< }|"Title$a$5CJOJQJHH  Balloon TextCJOJQJ^JaJ4"4 Header  !4 @24 Footer  !PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] + ???B    !,B8@0(  B S  ?&'Ac 6C'*44CDknFFGJSSUUVV&'Ac 6C'*44knGJSSUUVV 8C}|"j41T"^+*cakr mz$gT O _ug% -ug_=rG -:pROY @X@UnknownG.Cx Times New Roman5Symbol3. *Cx Arial3.Cx TimesS PalatinoBook Antiqua5. .[`)TahomaA$BCambria Math"1h;;;  &pn43qHP ?g%2!xx 2Request to Withdraw from Emergency/Sick Leave Bankuser Anna MoskalOh+'0  4@ ` l x 4Request to Withdraw from Emergency/Sick Leave BankuserNormal Anna Moskal2Microsoft Office Word@@F/#@^#@^#՜.+,0, hp  91Ƭ  4Request to Withdraw from Emergency/Sick Leave Bank Title  !"#$%&()*+,-.1Root Entry F`#31Tablex WordDocument4SummaryInformation(DocumentSummaryInformation8'CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q