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Cortland County Personnel/Civil Service 60 Central Avenue Cortland NY 13045-2746 [PHONE REDACTED] LAURIE L. LEONARD PAM ABBOTT PERSONNEL OFFICER DEPUTY PERSONNEL OFFICER SUBMIT TO THE PERSONNEL DEPARTMENT DONATIONS TO THE EMERGENCY POOL I make the following donation(s) to the emergency pool: For Name of employee to receive donation My Name Title Donor Department I work hours per week Employees who earn benefit time may donate time to the emergency pool in full hourly increments. Vacation hours Compensatory hours Holiday/Floating Holiday hours Personal hours Sick hours Donors must retain a minimum of 10 days of accruals in sick leave balance. Donor identity shall be kept confidential. Time donated may not be revoked by the donor. All donations are subject to the Emergency Pool Policy. The Emergency Pool Policy is located on the Personnel Department’s webpage. I understand that I will be notified by the Personnel Department upon usage of my donated time. I further understand that my department will be notified when my leave accruals are used for this purpose. Signature Date