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Get Va Form 0239

U.S. DOD Form dod-va-0239 LEAVE TRANSFER AUTHORIZATION INSTRUCTIONS Complete Part I and submit the form to your Human Resources Management Office. PRIVACY ACT STATEMENT Participation in this program is voluntary however solicitation of this information is authorized by P. L* 100-566 October 31 1988. This information furnished will be used to identify records properly associated with the leave donation* It may also be disclosed to a national State or local law enforcement agency where there is an indication of a violation or potential violation of civil or criminal law rule or regulation or to another agency or court when the Government is party to a suit. Furnishing the Social Security Number as well as other data is voluntary but failure to do so may delay or prevent action on the request to donate leave. PART I - TO BE COMPLETED BY LEAVE DONOR NAME OF DONOR Last First M. I. SOCIAL SECURITY NUMBER ORGANIZATION UNIT GRADE Include step SALARY RATE NAME OF RECIPIENT OF DONATED LEAVE AMOUNT OF DONATED LEAVE HOURS/DAYS OF REGULAR ANNUAL LEAVE SIGNATURE OF DONOR DATE SIGNED AUTHORIZATION - I authorize transfer of leave to the above-named recipient. PART II - ACTION BY HUMAN RESOURCES MANAGEMENT OFFICE I have reviewed the current positions and the grade pay levels of the above-named donor and leave recipient and certify that this request meets does not meet the administrative requirement for leave transfer. COMMENTS SIGNATURE TITLE This leave is transferred on the date indicated below. AMOUNT OF LEAVE EFFECTIVE DATE HOURS/DAYS DATE PERSONAL EMERGENCY ENDED VA FORM APR 2000 R HOURS/DAYS OF ANNUAL LEAVE RESTORED TO DONOR DATE RESTORED INITIALS OF PAYROLL CLERK JetForm. PRIVACY ACT STATEMENT Participation in this program is voluntary however solicitation of this information is authorized by P. L* 100-566 October 31 1988. This information furnished will be used to identify records properly associated with the leave donation* It may also be disclosed to a national State or local law enforcement agency where there is an indication of a violation or potential violation of civil or criminal law rule or regulation or to another agency or court when the Government is party to a suit. L* 100-566 October 31 1988. This information furnished will be used to identify records properly associated with the leave donation* It may also be disclosed to a national State or local law enforcement agency where there is an indication of a violation or potential violation of civil or criminal law rule or regulation or to another agency or court when the Government is party to a suit. Furnishing the Social Security Number as well as other data is voluntary but failure to do so may delay or prevent action on the request to donate leave. Furnishing the Social Security Number as well as other data is voluntary but failure to do so may delay or prevent action on the request to donate leave. PART I - TO BE COMPLETED BY LEAVE DONOR NAME OF DONOR Last First M. I. SOCIAL SECURITY NUMBER ORGANIZATION UNIT GRADE Include step SALARY RATE NAME OF RECIPIENT OF DONATED LEAVE AMOUNT OF DONATED LEAVE HOURS/DAYS OF REGULAR ANNUAL LEAVE SIGNATURE OF DONOR DATE SIGNED AUTHORIZATION - I authorize transfer of leave to the above-named recipient.

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