PST Request Form – New York Payroll Associates

Associate Information

Name*

First Last

Client for which you are currently working:*

Phone*

Email*

Paid Sick Time Information

PLEASE INDICATE YOUR APPROVAL:*

Paid Sick Time Request: I am choosing to use PST

In which city do you currently work:*

Only Payroll Associates who are currently WORKING in the areas below are eligible for Paid Sick Time. If you do not work in these locations, you are not eligible to request PST. Please note, PST ordinances are available in eOffice, if further clarification is required.

New York City
Westchester County
Other

Paid Sick Time (PST) Request Form for NYC:

Up to a maximum of 40 hours of sick leave may be used as in a calendar year. Earned PST may be taken on the 121st calendar day of the effective date of the city-specific sick pay mandate or on the 121st calendar day of employment, whichever is later. Atrium’s calendar year is defined as January 1 to December 31.

Sick leave may be taken in four (4) hour increments. If the sick leave is foreseeable, you must verbally notify your immediate supervisor and Atrium counselor no more than seven days in advance of the need for leave. PST is paid at your current hourly rate.

If your assignment ends at any point, earned but unused PST is not paid out. If you go back to work within six (6) months, and have met the eligibility requirements, you are able to use earned sick time accrued before the break in service.

You must be on an active assignment to be eligible for a PST payment, and submission may not be more than 14 days from the date of request.

*PST may only be requested in 4-hour increments up to 8 hours per day.

Paid Sick Time (PST) Request Form for Westchester County:

Up to a maximum of 40 hours of sick may be used in a calendar year. Earned sick leave may be taken on the 91st calendar day of the effective date of the city-specific sick pay mandate or on the 91st calendar day of employment, whichever is later. Atrium’s calendar year is defined as January 1 to December 31.

Sick leave may be taken in four (4) hour increments. If the sick leave is foreseeable, you must verbally notify your immediate supervisor and Atrium counselor no more than seven days in advance of the need for leave. PST is paid at your current hourly rate.

If your assignment ends at any point, earned but unused PST is not paid out. If you go back to work within nine (9) months, and have met the eligibility requirements, you are able to use earned sick time accrued before the break in service.

You must be on an active assignment to be eligible for a PST payment, and submission may not be more than 14 days from the date of request.

*PST may only be requested in 4-hour increments up to 8 hours per day.

If you do not work in New York City or Westchester County, you are not eligible to request PST.

Date of PST Requested

Number of Hours Requested*

*PST may only be requested in 4-hour increments up to 8 hours per day

Additional Date of PST Requested

Number of Hours Requested

*PST may only be requested in 4-hour increments up to 8 hours per day

Additional Date of PST Requested

Number of Hours Requested

*PST may only be requested in 4-hour increments up to 8 hours per day

Reason for request:*

Care for yourself
Care for a family member
Official public pronouncement

Eligibility Requirements:

Your PST request will be reviewed by Payroll to ensure eligibility requirements have been met. Please allow 7-14 business days for approval and processing of payment. If eligibility requirements are not met, Payroll will contact you.

pAId sick time request

new york

Associate Information

Paid Sick Time Information

Eligibility Requirements:

WorkFORCE SOlutions

Talent TEchnology

About