Emergency Vacation Sharing Recipient Form

I have suffered a catastrophic event related to Hurricane Harvey.

I have exhausted all of my available vacation, personal, and floating time (if applicable) and I am requesting approval to use vacation hours donated to the Vacation Sharing pool.

I understand that I may not convert the vacation days(s) received under the plan into cash in lieu of using the vacation.

Participation in this program is voluntary. The information furnished will be used to identify records properly associated with the transfer of vacation time. This form will be retained by the Office of Human Resources/Regulatory Compliance.