Work Years And Personnel Costs Report-Leave Earned And Used {OPM 1351C}

WORK YEARS AND PERSONNEL COSTS REPORT LEAVE EARNED AND USED LEAVE YEAR 1. Agency Name Leave Used Type of Leave 1. Total Annual 1a. Annual Lump-Sum Payments (separately) 2. Sick 3. Holidays 4. Time-Off Awards 5. Other Leave for Employees Covered by 5 U.S.C. 6301 XX XX XX XX Number of Days (1) (2) Value (Thousands) (1) (2) XX XX XX XX XX XX XX XX Earned Number of Leave Days: Carried Over End of Year Forfeited End of Year 2. Agency Code Credited For Retirement XX XX XX XX XX XX 6. Other Leave3 for Employees not Covered by 5 U.S.C. 6301 1 Includes lump-sum payments for annual leave paid to separating employees. 2 Lump-sum payments shown separately. 3 Leave granted to employees not covered by chapter 63 of title 5, U.S. Code, regardless of type of leave. Specify categories of employees for whom this type of leave is reported. OPM Form 1351-C (Rev. 11/97) American LegalNet, Inc. www.FormsWorkFlow.com