Vacation Cash out Request Cash Out Form Name (Please Print) Emp ID # Department I would like to request the following cash out in Year: 2025 # of Hours All cash out request forms must be received by December 31st. Employees will be allowed to "cash-out" vacation hours once per year, up to 80 hours (Min. of 5 hours for payout). If an employee used the vacation hours slated to be cashed out, only those hours accrued, but unused, will be cashed out. Once submitted, a cash-out election cannot be changed and is irrevocable. By typing your name below, you acknowledge that it will serve as your electronic signature, indicating your agreement and consent to the terms of this form. Authorization: Employee Signature Print Name Date
