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Leave Without Pay Forms

LWOP Procedures

Complete an SF-52 as soon as you know the effective date. The SF-52 must be received by Human Resources at least one pay period prior to the start date. Use the beginning  of the first full pay period of LWOP as the start date on the SF-52. If needed, use the time sheet to record LWOP just prior to that date. Notify the area Timekeeper of this action.

These documents may require Adobe Acrobat.

Microsoft Word Document.SF-52 Request for Personnel Action (sample) (117kb)

Adobe Acrobat Document.AD-139 Final Salary Report (91kb)

Adobe Acrobat Document.AD-349 Employee Address (if change) (25kb)

Microsoft Word Document.Federal Employees Health Benefits (FEHB) Options While in Nonpay Status (33kb) - Must complete this form if they carry FEHB and are eligible to continue carrying it while on LWOP.

Complete Performance Appraisal - if completed 90 days in appraisal period and will not return to duty prior to October.

If employed under the Student Employment Program, also complete these two forms:
Adobe Acrobat Document.Trainee Comments (72kb) (for STEP & SCEP only)
Adobe Acrobat Document.Student Trainee Evaluation (81kb) (for STEP & SCEP only)

 

 



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