Form CALHR 878 2018 Department Certification of Funding and Participation - California

Form CALHR878 or the "Department Certification Of Funding And Participation" is a form issued by the California Department of Human Resources.

The form was last revised in March 1, 2018 and is available for digital filing. Download an up-to-date Form CALHR878 in PDF-format down below or look it up on the California Department of Human Resources Forms website.

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California Department of Human Resources
Print Form
State of California
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2018 Department Certification of Funding and Participation
Bargaining Units 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21
Vacation/Annual Leave Cash Out Program
1. Please identify the bargaining units (BUs) your department currently has employees in: (check all that
apply)
BU 1 - SEIU
BU 17 - SEIU
BU 8 - CalFire
BU 13 - IUOE,
Local 2881
Locals 39, and
BU 2 - CASE
BU 18 - CAPT
50, AFL-CIO
BU 3 - SEIU
BU 9 - PECG
BU 19 - AFSCME
BU 14 - SEIU
BU 4 - SEIU
BU 10 - CAPS
BU 20 - SEIU
BU 15 - SEIU
BU 6 - CCPOA
BU 11 - SEIU
BU 21 - SEIU
BU 16 - UAPD
BU 7 - CSLEA
BU 12 - IUOE
2. Please check the applicable statement:
The department has employees in one or more of the above BUs, but will not participate in the Vacation/
Annual Leave Cash Out Program for fiscal year 2017-18.
The department will participate in the Vacation/Annual Leave Cash Out Program for fiscal year 2017-18.
Participation will not require supplemental funding.
Projected departmental cost of the cash out for this fiscal year is $
Employees in eligible bargaining units are eligible to cash out up to
hours
3. I hereby certify that our department's participation in the Vacation/Annual Leave Cash Out Program is as
indicated above.
Signature of Agency Head/Representative
Date
Name (Printed)
Title
Contact Person Name
Title
Telephone Number
Department Name
cc:
, Department of Finance Budget Analyst
CalHR 878
Page 1 of 1
(rev 03/2018)
California Department of Human Resources
Print Form
State of California
Reset Form
2018 Department Certification of Funding and Participation
Bargaining Units 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21
Vacation/Annual Leave Cash Out Program
1. Please identify the bargaining units (BUs) your department currently has employees in: (check all that
apply)
BU 1 - SEIU
BU 17 - SEIU
BU 8 - CalFire
BU 13 - IUOE,
Local 2881
Locals 39, and
BU 2 - CASE
BU 18 - CAPT
50, AFL-CIO
BU 3 - SEIU
BU 9 - PECG
BU 19 - AFSCME
BU 14 - SEIU
BU 4 - SEIU
BU 10 - CAPS
BU 20 - SEIU
BU 15 - SEIU
BU 6 - CCPOA
BU 11 - SEIU
BU 21 - SEIU
BU 16 - UAPD
BU 7 - CSLEA
BU 12 - IUOE
2. Please check the applicable statement:
The department has employees in one or more of the above BUs, but will not participate in the Vacation/
Annual Leave Cash Out Program for fiscal year 2017-18.
The department will participate in the Vacation/Annual Leave Cash Out Program for fiscal year 2017-18.
Participation will not require supplemental funding.
Projected departmental cost of the cash out for this fiscal year is $
Employees in eligible bargaining units are eligible to cash out up to
hours
3. I hereby certify that our department's participation in the Vacation/Annual Leave Cash Out Program is as
indicated above.
Signature of Agency Head/Representative
Date
Name (Printed)
Title
Contact Person Name
Title
Telephone Number
Department Name
cc:
, Department of Finance Budget Analyst
CalHR 878
Page 1 of 1
(rev 03/2018)

Download Form CALHR 878 2018 Department Certification of Funding and Participation - California

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