Op 44 Form PDF Details

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QuestionAnswer
Form NameOp 44 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnyc doe termination pay, op 44 termination pay form, op 44 installments paid, op 44

Form Preview Example

New York City Department of Education

Phone: 718-935-2218

Pedagogic/School Based Payrolls

PLEASE TYPE PART 1 OF THE OP44 FORM.

65 Court Street, Room 1400

 

Brooklyn, New York 11201

Form: OP-44

APPLICATION FOR TERMINATION PAY FOR PEDAGOGUES

PART I - To be completed by applicant and submitted to payroll secretary for completion of Part III.

The DOE wants to hear from our employees. Please take the time to complete an anonymous exit survey at:

File No

Name

Address

City

School

License

 

 

 

 

 

 

 

SSNEMPL ID

 

 

 

 

 

 

 

Teacher Regular

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Zip Code

Dist

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Borough

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emp Tele #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I hereby request termination pay on the basis of the following terms and conditions.*

Teachers who resign or retire shall, upon application, receive termination pay on the basis of one half of up to 200 days of the unused sick leave accumulated

as a regularly appointed or regular substitute teacher. If the resignation or retirement becomes effective at any time other than the end of a school year, sick leave for the period of services during that school year shall be paid at the rate of one day for each two full months of service.

*Extracts from Art. Sixteen 16A, 17, 18 & 19. Agreement between the Board of Education & UFT covering Teachers, Oct. 16, 1995 - Nov. 12, 2000. (Substantially identical provisions appear in other agreements with UFT and CSA).

Reason

Applicant Signature

Effective Current Date

PART II - For CSA Members Only - The following must be completed and signed by immediate supervisor of all school based supervisors in order for termination pay to be processed immediately.

Has 90 Day Notice of retirement / resignation been provided?

No *

Yes

Date Notice Provided

*Please Note: School - Based supervisors who do not comply with this provision will have their final entitlement payment made in a lump sum two (2) years after their retirement / resignation.

Signature of Principal / Superintendent

Date

PART III - To be completed and reviewed by school payroll secretary and signed by Principal. Before any computation of terminal leave or termination pay, adjust C.A.R. so that it does not exceed 200 days.

A)Number of days remaining in Applicant's Cumulative Absence Reserve after all deductions for illness and (if granted) deduction of twice the number of school days of Terminal Leave.

B)It is hereby certified that the above-named applicant is entitled to the amount of days of Termination Pay (Half of A) shown here.

Date

Timekeeper or Payroll Secretary

Signature of Principal / Superintendent

Signature of Pri cipal

School's Tele #

Title, if Other

Note: If the applicant does not wish to be paid until a future year. Please indicate the year

Central Office Use Only:

Certified by

OD Rev 12/2007

Paid On

Date Printed

0 6

0 2 2 0 2 0

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