HUMAN RESOURCES DEPARTMENT
______________________________________________________
PTO TIME TRANSFER REQUEST
Per Section 05, 5.1.3C of the Town of Payson Personnel Policy: Paid Time Off may be
transferred from one employee to another on an hour for hour basis if an emergency situation
exists, both employees agree in writing to the transfer, and the transfer is approved by Human
Resources.
Prior to receiving transferred paid time off, an employee must begin FMLA leave.
**NOTE: Person receiving donated PTO must exhaust all of their own accrued paid leave prior
to receiving donated time.**
I, ___________________________________________, would like to transfer _________ hours
Print Name of Person Donating PTO # of Hours
of my PTO to ______________________________________________.
Print Name of Person Receiving Donated PTO
________________________________________________ _________________
Signature of Person Donating PTO Date
________________________________________________ _________________
Signature of Person Receiving Donated PTO Date
APPROVED BY:
________________________________________________ _________________
Human Resources Manager Date
MELANIE BAIRD-SIMMONS, HR MANAGER X5011
E-
MAIL mbaird-simmons@paysonaz.gov
K
ELLI SCHWEIN, HR ANALYST X5012
E-
MAIL kschwein@paysonaz.gov
K
ATHERINE JOST, PAYROLL SPECIALIST X5013
E-MAIL kjost@paysonaz.gov
TOWN OF
303 N BEELINE HWY
P
AYSON, AZ 85541
928
474-5242 FAX
928
474-1151
