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Employee Separation Payment Authorization Form

UNDERSTAND

The Employee Separation Payment Authorization (ESPA) form must be completed and submitted to the Payroll Office when an employee separates from University employment. This form authorizes payment of unused annual leave, unused compensatory time, and also authorizes the payment of sick leave at retirement. A form should be submitted even if the employee is not eligible to be paid for any leave.

The Online Work/Leave System (OWLS) will automatically generate the ESPA form when an employee’s OWLS record is ended due to separation and populate appropriate leave balances and employee information. OWLS will automatically populate the central budget number 12-2500 for unused annual leave at the time of separation and for unused sick leave at the time of death or retirement for separations after July 1, 2011 (payment types 1 or 2 and 5 on the ESPA form). Departments will need to enter the employee's full time rate, a contact phone number, and budget number(s) for compensatory time, and "pay in lieu of notice" for layoff (payment types 3 and 4 on the ESPA form.)

ACT

  1. Follow the instructions for ending a record.
  2. When the Separation Payment Worksheet is generated, enter the employee’s full time rate, the budget numbers that will be charged for payment types 3 and 4 and your phone number.
  3. Then scroll to the bottom of the page and click on the “Generate Separation Payment Authorization Form” button.
  4. Sign and date the form (need names/signatures of preparer & reviewer).
  5. Make copies and follow distribution instructions on the form.
  6. Submit signed original form to the Payroll office at Box 359555.
Note:

EXPLORE

At the time an employee retires from employment, or dies while still employed, the full balance of accrued sick leave hours is converted to payment at the rate of 25%. For retiring employees, the cash value is applied to the tax-free medical expense account that may be used by the retiree and eligible dependents to pay medical expenses after retirement. For more information about the medical expense account, please visit the VEBA page.

Ending Employment information

Entry of budget number information is restricted by the size of the form field, which limits the number of characters and lines (3). A comma will reflect a line break. The following example is the maximum spacing accepted into the worksheet:

"07-XXXX 50%,07-XXXX 10%,07-XXXX 40%"

 

To generate the form, you must have Adobe Reader version 6.0 or above.