Newcastle University Additional Annual Leave Request Form

Newcastle University – Additional Annual Leave Request Form

TITLE:Preferred first name:Personnel no:

Forename(s):Surname:

(as shown on passport)(as shown on passport)

Academic/Service Unit:

Email address:Extension:

You may apply for a number of days of additional annual leave. If approved, your annual salary will be reduced by an amount equivalent to the number of days / hours leave being taken; each day considered to be 1/260th of a year.

You can apply by 1 August for up to 10 days additional leave in the next leave year from

1 October or by 1 February for up to an additional 5 days in half of the leave year from 1 April. For staff who work part-time or are contracted to work more or less than a standard five day working week, the number of days will be pro-rata to the equivalent of two working weeks.

Number of days requested

Full-time staff please request number of days. Part-time staff please request number of hours

I wish to apply for an additional days / hours (delete as required) of annual leave in the year 20___ / 20___.

To be effective from (delete as required):October (maximum two working weeks)

April (maximum one working week)

Employee’s Declaration:

I confirm that, if approved, my salary will be reduced by an amount equivalent to the salary for the number of days / hours additional leave requested; each day considered to be 1/260th of a year.

I agree that this additional leave will be added to my annual leave and taken in the normal way by application to and approval by my line manager.

The deduction will be made: (please cross one)

One lump sum

10 / 4 monthly deductions from salary (please delete one)

In the event that I leave the University I agree to the outstanding amount being deducted from my final pay.

Signed:Date:

Manager’s Approval

I approve this request for additional annual leave

Line Manager:Signature:Date:

Print name:

Approved forms should be sent to the Payroll Section, King’s Gate.

Payroll use only

IT0014 Start date:End date:Amount:

Input by:Checked by:

Page 1 of 2Additional Annual Leave Request FormForm updated 05 August 2011