| 10.
Layoff - 36 1/4 hour week |
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| INSTRUCTIONS FOR COMPLETION: |
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| 1.
Complete Shaded Grey areas only |
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| 2.
Complete Tombstone Data |
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| 3.
Complete for Layoff |
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| 4.
Complete Leave Without Pay - for Leave > 3 months for Relocation of
Spouse, |
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| Personal Leave and Care &
Nurturing |
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| 5.
Complete separate row for each period where AWW differs |
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| 6.
To Save - Click on File - Hit "SAVE AS" - type in employees
last name and hit Save |
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| 7.
1 copy for file - 1 copy to employee |
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| NAME |
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CPC ID# |
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| P/L # |
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| Severance
Payable from: |
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to |
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(mm/dd/yy) |
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(mm/dd/yy) |
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LAYOFF |
If rights are exhausted |
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| 1ST DATE |
LAST DATE |
ASSIGNED |
# OF |
Full Time |
# OF DAYS |
# OF YEARS |
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| (mm/dd/yyyy) |
(mm/dd/yyyy) |
WW |
DAYS |
Daily Equiv. |
Full Time Equiv. |
Full Time Equiv. |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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| LEAVE WITHOUT PAY > 3
MONTHS (for Relocation of Spouse, |
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| Personal Leave and Care
& Nurturing) |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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0 |
0.00 |
0.00 |
0.00 |
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| TOTAL
FULL TIME EQUIVALENT YEARS |
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0.00 |
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MAX ALLOWED (completed yrs.) |
0 |
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0.00 |
| YEARLY SALARY = |
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SEVERANCE
DUE ON LAYOFF |
$0.00 |
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LAYOFF
CALCULATION - (2 weeks for 1st year & 1 week |
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after to max. Of 28 |
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Total # of years |
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0 |
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(1st year = 2 weeks) |
1 |
$0.00 |
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-1 |
$0.00 |
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