Form HCM-33A "Request to Receive Shared Leave/Bank Leave" - Oklahoma

What Is Form HCM-33A?

This is a legal form that was released by the Oklahoma Office of Management and Enterprise Services - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 20, 2020;
  • The latest edition provided by the Oklahoma Office of Management and Enterprise Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HCM-33A by clicking the link below or browse more documents and templates provided by the Oklahoma Office of Management and Enterprise Services.

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Download Form HCM-33A "Request to Receive Shared Leave/Bank Leave" - Oklahoma

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Request to Receive
Shared Leave/Bank Leave
Form HCM-33A
Employee Information
Employee name
PeopleSoft employee ID
Agency name
Agency #
Work location
I request approval to receive donated leave. I certify I am eligible for and require donated leave as authorized by
Oklahoma statutes (74 O.S. § 840-2.23).
Optional: Request leave from other agency
I affirm I have exhausted all annual and sick leave and am unable to receive donated leave within my agency.
Optional: HCM online Shared Leave Registry
I understand my first name, last initial and agency information will be placed on the Shared Leave Registry.
I understand this information will be available for review by anyone having internet access, including individuals
outside of state government, and accept complete responsibility for this request.
Optional: Request leave from Leave Bank
I affirm I have exhausted all annual and sick leave, and worked with my agency and the shared leave liaison, but
am unable to receive donated leave.
Employee signature
Date
Agency Verification and Approval
Agency contact name
Contact email
Phone
Employee’s leave balance
as of
as of
Annual hours
Date
Sick hours
Date
Previous shared leave usage (total hours):
(Interagency shared leave request)
Authorization to
(Leave Bank request only)
I verify employee has exhausted all
list on Shared
I verify employee has exhausted all
annual/sick leave and is unable to receive
Leave Registry
annual/sick leave and is unable to receive
donated leave within the agency.
donated leave through any available channels.
Signature of agency verifying official
Date
Approved
Disapproved
Signature of appointing authority
Date
Signature of HCM shared leave liaison (OMES use only)
Date
Provide a copy of the final approved/disapproved form to employee.
OMES – FORM HCM-33A (Revised 10/20/2020)
Request to Receive
Shared Leave/Bank Leave
Form HCM-33A
Employee Information
Employee name
PeopleSoft employee ID
Agency name
Agency #
Work location
I request approval to receive donated leave. I certify I am eligible for and require donated leave as authorized by
Oklahoma statutes (74 O.S. § 840-2.23).
Optional: Request leave from other agency
I affirm I have exhausted all annual and sick leave and am unable to receive donated leave within my agency.
Optional: HCM online Shared Leave Registry
I understand my first name, last initial and agency information will be placed on the Shared Leave Registry.
I understand this information will be available for review by anyone having internet access, including individuals
outside of state government, and accept complete responsibility for this request.
Optional: Request leave from Leave Bank
I affirm I have exhausted all annual and sick leave, and worked with my agency and the shared leave liaison, but
am unable to receive donated leave.
Employee signature
Date
Agency Verification and Approval
Agency contact name
Contact email
Phone
Employee’s leave balance
as of
as of
Annual hours
Date
Sick hours
Date
Previous shared leave usage (total hours):
(Interagency shared leave request)
Authorization to
(Leave Bank request only)
I verify employee has exhausted all
list on Shared
I verify employee has exhausted all
annual/sick leave and is unable to receive
Leave Registry
annual/sick leave and is unable to receive
donated leave within the agency.
donated leave through any available channels.
Signature of agency verifying official
Date
Approved
Disapproved
Signature of appointing authority
Date
Signature of HCM shared leave liaison (OMES use only)
Date
Provide a copy of the final approved/disapproved form to employee.
OMES – FORM HCM-33A (Revised 10/20/2020)