APPLICATION TO DONATE VOLUNTARY SHARED LEAVE

The purpose of voluntary shared (donated) leave is to provide economic relief for employees, who by reason  of prolonged absence caused by serious medical conditions of self or immediate family, are likely to suffer  financial hardship.  

An eligible DPS employee may donate vacation/bonus or sick leave to an immediate family member, who is  eligible to receive shared leave, in any North Carolina public school, state agency, or community college.  

An eligible DPS employee may donate the following leave to a non-family member: Vacation or bonus leave to an employee of the same or another LEA.

Vacation or bonus leave to a coworker’s immediate family who is an employee in a state agency or  community college.

Maximum of 5 sick leave days per year to a non-family member in the same or another LEA.

Donors may not reduce their sick leave balances below one-half of what can be earned in a year. Donated  sick leave shall not be used for retirement purposes. For the purposes of voluntary shared leave, all leave  donated will be credited to the recipient’s sick leave account. There is no provision for public school  employees to donate leave to or receive leave from employees in charter schools, or in county agencies of  mental health, public health, social services or emergency management including those covered by the State  Personnel Act. Donated leave paperwork should be sent to hrleaves@dpsnc.net.

Voluntary shared leave donations are confidential and voluntary. An employee should not be solicited or coerced by co-workers to donate leave days or receive compensation for donated leave days.  

 Individual Wishing to Donate Voluntary Shared Leave

Donor’s Name

Date

Employee ID or Last 4 of SS#

School System/State Agency

Name & email of HR contact  person from donating LEA or  state agency (if not DPS)

Recipient’s Name

Recipient’s Workplace

Relationship to  

Recipient/Donee

Total days to be donated

Type of Leave to be donated

Per State Board Policy #4.3:

Employees who donate sick leave shall be notified in writing of the State retirement credit consequences of  donating sick leave. That is, the sick leave balance provides an income safety net while employed. Sick  leave also has value at retirement. At retirement a member of the Teacher’s and State Employees’ Retirement  System (TSERS) with an earned sick leave balance receives an additional month of service credit in TSERS  for each 20 days, plus one additional month if there is a remainder. The additional service credit increases the  retirement benefit for the remainder of the life of the retiree.  

I understand the above consequences in donating sick leave and my signature authorizes the transfer of  sick/annual leave to the above-named recipient.  

Signature of Donor _____________________________________________ Date_____________________

________________________________________________________________________________________ Signature of HR Leave Analyst Date