Supplemental Pay Leave Request Form for Union Employees
Please select the form that best matches your needs from the options below.
Supplemental Pay Leave Request Form
If you are requesting to use your accrued time (e.g., vacation, sick/PTO) to supplement a Short-Term Disability (STD), Paid Family Leave (PFL), or Workers’ Compensation (WC) leave, please complete the Supplemental Pay Leave Request Form below.
FMLA Supplemental Pay – Change Request Form for Union Employees
If you are requesting to update or change how a previous FMLA absence was supplemented, please complete the FMLA Supplemental Pay – Change Request Form for Union Employees.
This Supplemental Pay Leave Request form is for SEIU/1199 union members (BU2/BU4) only.
You may also complete this form if you wish to receive Family Medical Leave Act correspondence related to your leave electronically during your leave.
Printer friendly version of the Supplemental Pay Leave Request Form for Union Employees