State of New York
Holiday Pay Waiver

(For Classified Service Employees in
Negotiating Units 01, 02, 03, 04, 05, 06, 31, and 61)

ALES Council 82 CSEA M/C NYSCOPBA PEF
(click the box in front of your negotiating organization)

Payroll Agency


I am eligible for additional money if I am required to work during my regular working hours on any day observed by the State as a holiday. Between April 1, and May 14, , I may give up my right to such additional money and choose to receive time accruals instead. If I previously gave up my right to receive money for holiday work, I have until May 14, to cancel this decision and start receiving money again.

I wish to change the way in which I am currently being paid for holiday work as follows:

I am now receiving money and I wish to change to receive time accruals
I am now receiving time accurals and I wish to change to receive money

I understand that this is the way I will receive holiday pay from now on. I will not be able to change this until at least April 1, and it will continue this way unless I do change it during the next open period.

Name:
(Please Type)

Work Location:      
Social Security Number:    
    _________________________   ________
    Signature   Date

Send to the campus payroll office by close of business May 14,