"Designation/Removal of Agency Leave Bank Coordinator" - Maryland

Designation/Removal of Agency Leave Bank Coordinator is a legal document that was released by the Maryland Department of Budget and Management - a government authority operating within Maryland.

Form Details:

  • Released on October 1, 2019;
  • The latest edition currently provided by the Maryland Department of Budget and Management;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of Budget and Management.

ADVERTISEMENT
ADVERTISEMENT

Download "Designation/Removal of Agency Leave Bank Coordinator" - Maryland

Download PDF

Fill PDF online

Rate (4.4 / 5) 10 votes
DBM - P
S
D
ERSONNEL
ERVICES
IVISION
S
E
L
B
TATE
MPLOYEES
EAVE
ANK AND
E
-
-E
L
D
P
MPLOYEE
TO
MPLOYEE
EAVE
ONATION
ROGRAM
D
/ R
A
L
B
C
ESIGNATION
EMOVAL OF
GENCY
EAVE
ANK
OORDINATOR
AGENCY NAME:
DATE:
AGENCY ADDRESS:
AGENCY HR DIRECTOR:
PHONE:
AGENCY LEAVE BANK COORDINATOR DESIGNATION:
The following individual is hereby authorized to serve as a Leave Bank Coordinator on behalf of the Agency
in matters related to the State Employees’ Leave Bank (Leave Bank) and Employee-to-Employee Leave
Donation Program. Upon successful completion of Leave Bank Training, this designation authorizes the
Agency Leave Bank Coordinator to:
1) review and appropriately process all required forms, and other related documents that an employee
has submitted, requesting to withdraw leave from the Leave Bank or the Employee-to Employee
Leave Donation Program;
2) submit to the Leave Bank Administrator within the Department of Budget and Management all
required forms and documents related to an employee’s request for leave from the Leave Bank; and
3) to receive determinations and/or a status regarding an employee’s request for leave from the Leave
Bank, or for a request for reconsideration of a denial of leave from the Leave Bank or in connection
with an appeal of the Agency’s denial for leave under the Employee-to-Employee Leave Donation
Program.
REASON FOR ADDING: New:
or
Transferred from:
LB Coordinator Name
Agency/Unit Name
Phone #
Email
REMOVE:
LB Coordinator Name
Agency/Unit Name
Reason
Effective Date
APPROVED BY:
________________________________________
___________________
Signature of Agency HR Director or Designee
Date
Please return completed form via fax or email to:
Fax: (410) 333-7671 or Yvette.romero@maryland.gov
LBCDesignation_10/2019
DBM - P
S
D
ERSONNEL
ERVICES
IVISION
S
E
L
B
TATE
MPLOYEES
EAVE
ANK AND
E
-
-E
L
D
P
MPLOYEE
TO
MPLOYEE
EAVE
ONATION
ROGRAM
D
/ R
A
L
B
C
ESIGNATION
EMOVAL OF
GENCY
EAVE
ANK
OORDINATOR
AGENCY NAME:
DATE:
AGENCY ADDRESS:
AGENCY HR DIRECTOR:
PHONE:
AGENCY LEAVE BANK COORDINATOR DESIGNATION:
The following individual is hereby authorized to serve as a Leave Bank Coordinator on behalf of the Agency
in matters related to the State Employees’ Leave Bank (Leave Bank) and Employee-to-Employee Leave
Donation Program. Upon successful completion of Leave Bank Training, this designation authorizes the
Agency Leave Bank Coordinator to:
1) review and appropriately process all required forms, and other related documents that an employee
has submitted, requesting to withdraw leave from the Leave Bank or the Employee-to Employee
Leave Donation Program;
2) submit to the Leave Bank Administrator within the Department of Budget and Management all
required forms and documents related to an employee’s request for leave from the Leave Bank; and
3) to receive determinations and/or a status regarding an employee’s request for leave from the Leave
Bank, or for a request for reconsideration of a denial of leave from the Leave Bank or in connection
with an appeal of the Agency’s denial for leave under the Employee-to-Employee Leave Donation
Program.
REASON FOR ADDING: New:
or
Transferred from:
LB Coordinator Name
Agency/Unit Name
Phone #
Email
REMOVE:
LB Coordinator Name
Agency/Unit Name
Reason
Effective Date
APPROVED BY:
________________________________________
___________________
Signature of Agency HR Director or Designee
Date
Please return completed form via fax or email to:
Fax: (410) 333-7671 or Yvette.romero@maryland.gov
LBCDesignation_10/2019