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reason_choice
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I request that my status as PSAC member in good standing be maintained while I am on unpaid leave.
I request that my status as PSAC member in good standing be maintained until the Phoenix pay system has reinstated payment of my union dues.
Please Choose
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Disability or illness
Workplace accident
Care of family member or family obligations
Maternity, parental or adoption leave
Layoff, termination or suspension
Other - Please Specify
More Details?
Provide any additional details you would like to add below.
My leave will begin on:
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Month
Month
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May
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Aug
Sep
Oct
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Day
Day
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Year
Year
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2017
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My anticipated return date is:
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Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
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Year
Year
2016
2017
2018
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2020
I confirm that during the above leave period leave I will not have alternate paid employment.
*
I confirm that during the above leave period, I will not have alternate paid employment.
pay_action_request
*
I have submitted a Pay Action Request to my Employer so that deduction of my union dues may resume/begin.
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