Ohr Form 400A PDF Details

The Ohr Form 400A is a document used to report an organization’s exempt status to the IRS. This form must be filed annually, and it provides the IRS with information about the organization’s exempt status, including its tax filing history and contact information. Though the form may seem daunting at first glance, it’s important for organizations with exempt status to file it every year. Failing to do so can result in penalties from the IRS. Luckily, there are plenty of resources available to help you complete the form accurately and on time.

You will discover information regarding the type of form you want to submit in the table. It will show you the time it will take to complete ohr form 400a, exactly what parts you will need to fill in and several further specific details.

QuestionAnswer
Form NameOhr Form 400A
Form Length1 pages
Fillable?Yes
Fillable fields32
Avg. time to fill out6 min 43 sec
Other namesdoe leave form, application for leave of absence form state of hawaii, hawaii doe leave of absence form, hawaii doe leave of absence

Form Preview Example

APPLICATION FOR LEAVE OF

ABSENCE CERTIFICATED

SCHOOL-LEVEL EMPLOYEES

DOE OHR 300-001

Last Revised: 01/01/2011

Former DOE Form(s): 400, 400a, 400a.1, 400F

DEPARTMENT OF EDUCATION

Ofice of Human Resources Records and Transactions Section, Certificated

P.O. Box 2360 Honolulu, HI 96804

I. EMPLOYEE INFORMATION

 

 

 

Name: _____________________________________________________________

Last 4 digits of SSN: _____________________

Last

First

M.I.

 

Address: _________________________________________

City: _____________________ State: _______ Zip: ______________

Tel#: ________________________

Position: _________________________

School/Office: ______________________________

School or Sub-Division Code: _ _ _

Leave Code: _ _ _

Bargaining Unit Code: _ _

II. LEAVE REQUEST (Complete appropriate subsection below.)

Family 1

 

Military 4

 

Political 5

 

Other: __________________

 

 

 

Funeral 2

 

Personal

 

Sick 3

 

 

 

 

 

 

 

 

 

 

Health, LWOP 3

 

Personnel Development

 

Vacation

 

 

1Complete and attach Federal Form WH-380F or WH-380E(Sde).

3Complete Licensed Physician's Statement by completing Section IV at bottom of this form for Health leave or if Sick leave for more than five (5) consecutive days or submit a signed doctor's note verifying current health condition. Approval for sick leave is subject to the availability of accumulated sick leave.

2Provide relationship to deceased and address if out of state in #2 below.

4Attach a copy of your military orders with this form (copy) to OHR, Records and Transactions Section, Certificated.

5Attach a separate letter justifying political appointment.

I hereby request the following type of leave:

 

 

Leave with Pay

 

 

Leave without Pay for the calendar period below:

From: _______________________

To: _______________________

_________________

MM/DD/YYYY

 

 

MM/DD/YYYY

# of working days

1. Is this an extended leave?

 

 

Yes

 

 

 

No

 

 

 

 

2.Provide any additional explanation for leave request (attach a separate sheet if necessary):

________________________________________________________________________________________________________

Employee Signature: _______________________________________________________ Date: _______________________

MM/DD/YYYY

III. LEAVE APPROVAL

For sick, vacation, and personal leave, Principal/Immediate Supervisor approval required.

For family, military, personnel development, and political leave,both Principal/Immediate Supervisor and PRO/CAS approval required.

Approved

Principal/Immediate

 

 

 

Not Approved Supervisor Signature: __________________________________________

Date: _________________

Approved

 

MM/DD/YYYY

 

 

Not Approved PRO/CAS Signature: ________________________________________

Date: _______________

 

MM/DD/YYYY

IV. LICENSED PHYSICIAN'S STATEMENT

(To be completed ONLY for HEALTH LEAVE or if SICK LEAVE is for more than five (5) consecutive work days)

I certify that _________________________________ is under my care for health reasons and is not physically able to perform

his/her normal work duties from _______________________ to ______________________.

MM/DD/YYYYMM/DD/YYYY

Licensed Physician Signature: ________________________________________

Date: _______________________

 

MM/DD/YYYY

Name of Licensed Physician (Print): __________________________________

Type of Practice: ___________________________

Address: __________________________________________________________

Tel#: ____________________________________

Distribution: Leave with Pay (Teachers): 1. Original - School; 2. Copy 1 - Employee; 3. Copy 2 - PRO (if leave exceeds one month) / Leave With Pay (EOs): 1.

Original - School; 2. Copy 1 - Employee / Leave Without Pay and Military Leave With Pay: 1. Original - OHR, Records and Transactions Section, Certificated; 2. Copy 1 - Employee; 3. Copy 2 - School; 4. Copy 3 - PRO; 5. Copy 4 - Payroll Office, Leave Accounting Section

(Page 1 of 1)

How to Edit Ohr Form 400A Online for Free

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Step 1: Hit the orange button "Get Form Here" on the following webpage.

Step 2: Now you are on the file editing page. You can edit, add information, highlight certain words or phrases, place crosses or checks, and include images.

The next few sections are what you will have to create to receive the finished PDF document.

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You should submit your information inside the segment EmployeeSignatureDate, MMDDYYYY, IIILEAVEAPPROVAL, Date, ApprovedNotApprovedPROCASSignature, MMDDYYYY, Date, MMDDYYYY, MMDDYYYY, MMDDYYYY, LicensedPhysicianSignatureDate, and MMDDYYYY.

Completing tseas hawaii doe stage 2

Step 3: As soon as you select the Done button, the final document is easily exportable to each of your gadgets. Alternatively, you might deliver it by using mail.

Step 4: To prevent yourself from potential upcoming complications, it is important to have no less than two duplicates of each separate file.

Watch Ohr Form 400A Video Instruction

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