Professional Documents
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If you take approved leave without pay for a period in excess of nine working days, you are required to submit a Commencement Advice Form through your supervisor when you resume duty. Failure to do so will delay the resumption of your salary payments. Please read the instructions on the reverse side before completing the form. Detailed information regarding leave can be found in the Education Policy and Procedure Register. Employee Number: Surnam e: Position Title: (eg Teacher, Teacher Aide) Position Location: Employment Status: Permanent FullTime Forwarding address during period of leave: Location Code: Permanent Part-Time Temporary FullTime Temporary PartTime Title: (eg Mr/Mrs/Ms/Miss/Dr) Given Nam es:
Street: Suburb and Post Code: Telephone Number: From: Lump sum / / To: / /
Method of Payment:
Two lump sum payments split over financial years if applicable / / Yes To: Adoption Yes No / /
Is the leave to be paid at the half pay rate?: Parental Leave: From:
Maternity Spousal If required, is there medical clearance to continue working until the date of leave? Estimated date of / / confinement: required) Is the paid component of maternity leave to be paid at the half pay rate?: WorkCover: From: / /
No
Date of Injury: / / The following information should be attached to the leave application and forwarded to your district office: (a) Compensation Claim Form for Workers and (c) Accident report form Employers (d) Employment Declaration (taxation form) (b) WorkCover Medical Certificate (pink and blue copies) Special Leave: / / From: To: (greater than five days) / / Cultural Leave: (greater than five days) From: / / To: / /
Complete if you are cancelling or changing leave already approved and applied for. From: / / To: / /
EMPLOYEE CERTIFICATION: I certify that the above information is correct. Employees Signature: PRINCIPAL / APPROVING OFFICER APPROVAL: Principal / Approving Officers Signature:
Date:
Date:
DISTRICT DIRECTOR / DISTRICT OFFICE / CENTRAL OFFICE APPROVAL (if required): Signature: PROCESSING UNIT USE ONLY: Date Processed: Initials: / / Date: Fortnight End Date: Verified By: / / / /
Uncontrolled copy. Refer to HRM-PR-007 Leave entitlements for Employees at http://education.qld.gov.au/strategic/eppr/hr/hrmpr007/ for master.
TRIM 09/196223
Uncontrolled copy. Refer to HRM-PR-007 Leave entitlements for Employees at http://education.qld.gov.au/strategic/eppr/hr/hrmpr007/ for master.
Application for Leave leave. A part-time employee may access long service leave at fractions that they have previously worked, including full-time. Note: The increase in fraction is for the purposes of Long Service Leave only and does not include an increase in fraction for the mid-year vacations. Provisions relating to payment (cash equivalent of Long Service Leave) on termination after 7 years continuous service apply only if: (a) the employee terminates his or her service because of ill health or incapacity that are significant but does not qualify for ill health retirement; or (b) a domestic or other pressing necessity; or (c) the employer dismisses the employee for a reason other than the employees conduct, capacity or performance; or (d) the employer unfairly dismisses the employee
confirm their return with their Manager. PRIVACY: The Department is collecting personal information on this form in accordance with Human Resource systems and business processes. The form will be securely stored within the relevant Central Office, District Office or Payroll Services Centre. The information may be disclosed to third parties without your consent. Third parties include Government Superannuation Office, Australian Taxation Office, Queensland College of Teachers, Department of Employment and Industrial Relations, Industrial organisations or other entities in accordance with or where requested by law or industrial instrument.
PRIVACY: The Department is collecting personal information on this form in accordance with Human Resource systems and business processes. The form will be securely stored within the relevant Central Office, District Office or Payroll Services Centre. The information may be disclosed to third parties without your consent. Third parties include Government Superannuation Office, Australian Taxation Office, Queensland College of Teachers, Department of Employment and Industrial Relations, Industrial organisations or other entities in accordance with or where requested by law or industrial instrument.
Uncontrolled copy. Refer to HRM-PR-007 Leave entitlements for Employees at http://education.qld.gov.au/strategic/eppr/hr/hrmpr007/ for master.
TRIM 09/196223