For Department Payroll Use Only

Departments file the Vacation/Sick Pay Adjustment Form when an employee’s sick pay and/or vacation balances and/or entitlements need to be adjusted.  Three versions are available based years of service with the City and County of San Francisco. For employees working less than five years, use the 0 – 4  year form.  For employees working between five and 14.99 years, use the 5-14 form. For employees working fifteen or more years, use the 15+ form.