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The OHR 400A form serves as a vital tool for certificated school-level employees within the Hawaii Department of Education, allowing them to formally request a leave of absence. This application is structured to gather necessary employee information, such as the individual's name, last four digits of their Social Security number, and their current position. It also provides various leave categories, including family, military, personal, funeral, and sick leave, allowing employees to specify the type of leave desired. To facilitate the approval process, the form outlines the requirements for each leave type, such as additional documentation for health-related absences or military orders for military leave requests. Employees must indicate whether the leave is with or without pay and provide relevant dates for the requested absence. The approval section mandates signatures from the principal and other relevant authorities, ensuring proper oversight of leave requests. Finally, if the leave request is for health reasons or extends beyond five consecutive workdays, a licensed physician's statement must be included, further emphasizing the importance of clear and thorough documentation in managing employee absences.

Ohr 400A Example

APPLICATION FOR LEAVE OF

ABSENCE CERTIFICATED

SCHOOL-LEVEL EMPLOYEES

DOE OHR 300-001

Last Revised: 01/01/2011

Former DOE Form(s): 400, 400a, 400a.1, 400F

DEPARTMENT OF EDUCATION

Ofice of Human Resources Records and Transactions Section, Certificated

P.O. Box 2360 Honolulu, HI 96804

I. EMPLOYEE INFORMATION

 

 

 

Name: _____________________________________________________________

Last 4 digits of SSN: _____________________

Last

First

M.I.

 

Address: _________________________________________

City: _____________________ State: _______ Zip: ______________

Tel#: ________________________

Position: _________________________

School/Office: ______________________________

School or Sub-Division Code: _ _ _

Leave Code: _ _ _

Bargaining Unit Code: _ _

II. LEAVE REQUEST (Complete appropriate subsection below.)

Family 1

 

Military 4

 

Political 5

 

Other: __________________

 

 

 

Funeral 2

 

Personal

 

Sick 3

 

 

 

 

 

 

 

 

 

 

Health, LWOP 3

 

Personnel Development

 

Vacation

 

 

1Complete and attach Federal Form WH-380F or WH-380E(Sde).

3Complete Licensed Physician's Statement by completing Section IV at bottom of this form for Health leave or if Sick leave for more than five (5) consecutive days or submit a signed doctor's note verifying current health condition. Approval for sick leave is subject to the availability of accumulated sick leave.

2Provide relationship to deceased and address if out of state in #2 below.

4Attach a copy of your military orders with this form (copy) to OHR, Records and Transactions Section, Certificated.

5Attach a separate letter justifying political appointment.

I hereby request the following type of leave:

 

 

Leave with Pay

 

 

Leave without Pay for the calendar period below:

From: _______________________

To: _______________________

_________________

MM/DD/YYYY

 

 

MM/DD/YYYY

# of working days

1. Is this an extended leave?

 

 

Yes

 

 

 

No

 

 

 

 

2.Provide any additional explanation for leave request (attach a separate sheet if necessary):

________________________________________________________________________________________________________

Employee Signature: _______________________________________________________ Date: _______________________

MM/DD/YYYY

III. LEAVE APPROVAL

For sick, vacation, and personal leave, Principal/Immediate Supervisor approval required.

For family, military, personnel development, and political leave,both Principal/Immediate Supervisor and PRO/CAS approval required.

Approved

Principal/Immediate

 

 

 

Not Approved Supervisor Signature: __________________________________________

Date: _________________

Approved

 

MM/DD/YYYY

 

 

Not Approved PRO/CAS Signature: ________________________________________

Date: _______________

 

MM/DD/YYYY

IV. LICENSED PHYSICIAN'S STATEMENT

(To be completed ONLY for HEALTH LEAVE or if SICK LEAVE is for more than five (5) consecutive work days)

I certify that _________________________________ is under my care for health reasons and is not physically able to perform

his/her normal work duties from _______________________ to ______________________.

MM/DD/YYYYMM/DD/YYYY

Licensed Physician Signature: ________________________________________

Date: _______________________

 

MM/DD/YYYY

Name of Licensed Physician (Print): __________________________________

Type of Practice: ___________________________

Address: __________________________________________________________

Tel#: ____________________________________

Distribution: Leave with Pay (Teachers): 1. Original - School; 2. Copy 1 - Employee; 3. Copy 2 - PRO (if leave exceeds one month) / Leave With Pay (EOs): 1.

Original - School; 2. Copy 1 - Employee / Leave Without Pay and Military Leave With Pay: 1. Original - OHR, Records and Transactions Section, Certificated; 2. Copy 1 - Employee; 3. Copy 2 - School; 4. Copy 3 - PRO; 5. Copy 4 - Payroll Office, Leave Accounting Section

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Form Characteristics

Fact Name Description
Form Purpose The Ohr 400A form is used by certificated school-level employees of the Department of Education in Hawaii to formally request a leave of absence.
Leave Types Employees can request various types of leave using this form, including family leave, military leave, personal leave, sick leave, vacation leave, and others.
Approval Process Approval from the Principal or Immediate Supervisor is required for sick, vacation, and personal leave, while family, military, personnel development, and political leave necessitate additional approval from a PRO or CAS.
Governing Law This form is governed by the administrative policies of the Hawaii Department of Education.

Guidelines on Utilizing Ohr 400A

Filling out the OHR 400A form is essential for employees seeking a leave of absence. Completing the form accurately helps ensure the process is smooth and efficient. After submitting the form, it will be reviewed by the appropriate authorities for approval before the leave can take effect.

  1. Begin by entering your personal information in the EMPLOYEE INFORMATION section. Write your full name, including last name, first name, and middle initial.
  2. Input the last four digits of your Social Security Number.
  3. Fill in your address, including the city, state, and zip code.
  4. Provide your telephone number.
  5. Specify your current position and the school or office where you work.
  6. Include the School or Sub-Division Code and the Leave Code.
  7. Determine the type of leave your are requesting in the LEAVE REQUEST section. Select from the options listed: Family, Funeral, Military, Sick, Personal, Health, Personnel Development, Political, or Vacation.
  8. If applicable, complete the additional requirements for each leave type as outlined (e.g., attach a doctor's note or military orders).
  9. Indicate whether your leave is Leave with Pay or Leave without Pay, and provide the calendar period for your leave request.
  10. Answer whether this is an extended leave by marking Yes or No.
  11. Provide any additional information regarding your leave request, attaching a separate sheet if necessary.
  12. Sign and date the form to confirm your request.
  13. Submit the form for approval from your Principal/Immediate Supervisor, who will sign and date it if approved.
  14. If your leave falls under specific categories, also obtain the signature of the PRO/CAS.
  15. If your leave is for Health or if Sick Leave exceeds five consecutive days, have a licensed physician complete the statement at the bottom of the form.
  16. Make sure you distribute copies of the submitted form according to the instructions provided for your specific leave type.

What You Should Know About This Form

1. What is the Ohr 400A form used for?

The Ohr 400A form is an application for leave of absence specifically for certificated school-level employees within the Department of Education. This form allows employees to formally request different types of leave, including personal, sick, military, and vacation leave.

2. Who needs to approve my leave request?

Approval for your leave request depends on the type of leave you are applying for. For sick, vacation, and personal leave, the Principal or immediate supervisor must approve your request. If you are requesting family, military, personnel development, or political leave, both the Principal and the Personnel Office Representative/Compensation and Advisory Services (PRO/CAS) need to provide their approvals.

3. What additional documentation must I submit with the Ohr 400A form?

Depending on the type of leave you are applying for, specific documentation may be required. For health or sick leave exceeding five consecutive days, provide a licensed physician's statement. If you're requesting military leave, include a copy of your military orders. Political leave requests require a separate letter justifying the appointment. Remember to check the details for each category when preparing your application.

4. How long can I request leave for?

You can request leave for the specific calendar period you indicate on the form. It is important to fill out both the start and end dates accurately. Be mindful of the total number of working days being requested to avoid any discrepancies in your application.

5. What happens if my leave request is denied?

If your leave request is denied, you will receive feedback from the approving authority, which will help clarify why it was not approved. It is advisable to communicate with your supervisor or the relevant authority to discuss your options moving forward. You may need to provide additional information or consider alternative solutions based on the circumstances of your request.

6. Can I change my leave request after submitting the Ohr 400A form?

Yes, if you need to change your leave request after submission, you should contact your Principal or immediate supervisor as soon as possible to discuss the changes. Depending on the status of your request, you might be required to submit an amended form to officially document the changes.

7. How is my leave recorded and tracked after approval?

Once your leave request is approved, the leave will be recorded within the school’s records and in the Department of Education’s system. You will receive a copy of the approved form for your personal records. This tracking ensures that both your school and relevant offices are aware of your leave status and can plan accordingly.

Common mistakes

When filling out the OHR 400A form, people often make several common mistakes that can delay their leave requests. One frequent error is failing to provide complete employee information. This includes not entering their full name, the last four digits of their Social Security Number, and accurate contact details. Incomplete information can lead to processing delays, so it's critical to double-check these entries.

Another mistake involves selecting the incorrect type of leave. Each option has specific requirements. For instance, leave for medical reasons necessitates a doctor's statement, while military leave requires supporting orders. Misidentifying leave type may result in immediate rejection of the request.

Some employees neglect to provide a clear explanation for their leave request. The form allows for additional comments, which are essential for context. If a leave is longer than five consecutive days, lack of clarity can stall approval. Attach a separate sheet if necessary to ensure your situation is fully understood.

Moreover, many applicants forget to sign and date the form. An unsigned application is not valid and will lead to delays in processing. Both the employee and their supervising authority must provide signatures before submission.

Signatures are not the only overlooked details. Individuals frequently forget to include required documentation. For example, military leave requests must include a copy of military orders, whereas health-related leaves require a licensed physician's statement. Always check the checklist of requirements to ensure all necessary documents accompany your form.

In addition, employees often misinterpret the approval process. Understanding who needs to approve which type of leave is crucial. Not all leaves need the same level of approval; some require both the Principal and PRO/CAS approval, while others only need one signature.

Another common oversight is miscalculating the leave dates. Ensure the start and end dates are listed correctly. Errors can lead to confusion and potential issues with payroll. Verify the dates are accurate before submitting the form.

Additionally, failing to keep a copy of the submitted application is a common yet problematic mistake. Retaining a copy allows you to track your request and provides proof of submission if any issues arise in the future.

Lastly, some employees submit their forms too late. Each type of leave may have different deadlines for submission. Submit your application as early as possible to avoid complications and ensure you have adequate time to address any arising issues.

Documents used along the form

The OHR 400A form is a crucial document for certificated school-level employees seeking a leave of absence from their positions. Along with this form, several other related documents are often necessary to support an effective leave request and ensure compliance with institutional policies.

  • Federal Form WH-380F or WH-380E: These forms are required for family leave requests under the Family and Medical Leave Act (FMLA). They provide necessary certification from a healthcare provider regarding an employee's situation and the need for leave.
  • Licensed Physician's Statement: This statement is specifically for health-related leave requests. It must be filled out and signed by a licensed physician to certify that the employee is unable to perform normal duties due to health issues.
  • Military Orders: If the leave request pertains to military duties, a copy of the employee’s official military orders must be attached. This document serves as proof of duty and supports leave eligibility.
  • Personal Letter for Political Leave: Employees seeking leave for political appointments need to provide a separate letter that justifies their absence. This document explains the nature of the leave and the associated responsibilities.
  • Additional Explanation Sheet: If the employee's leave request requires further clarification, they may attach a separate sheet to provide additional details. This is important for transparency and proper evaluation of the leave.
  • Leave Approval Forms: Depending on the type of leave requested, various approval forms must be signed by the Principal/Immediate Supervisor and other relevant authorities. These signatures confirm that the leave request has been reviewed and approved according to institutional protocols.

Using the OHR 400A form alongside these related documents facilitates a smoother approval process for employees seeking leave. By ensuring all necessary paperwork is completed and submitted, individuals can minimize delays and better manage their leave of absence effectively.

Similar forms

  • OHR 300-001: This form is used to apply for leave of absence specific to certificated school-level employees within the Department of Education. Like the OHR 400A, it requires employee information and details regarding the type of leave being requested.

  • Federal Form WH-380F: This form is required to substantiate family and medical leave requests. Similar to the OHR 400A, it asks for specific information about the leave reason, ensuring compliance with federal regulations.

  • WH-380E: This form also relates to family and medical leave and provides a certification of the need for leave. It shares similarities with the OHR 400A in that both require detailed information about the employee’s circumstances.

  • Doctor's Note: A signed doctor's note may be submitted to validate health-related leave. Both documents require medical verification when requesting certain types of leave, establishing eligibility requirements.

  • OHR 400F: This document is specific to leave requests but focuses on family leave for certified employees. The processes for approval and the information needed are akin to those in the OHR 400A.

  • Leave Approval Request: This is an internal document that supervisors review for employee leave requests. Similar to the OHR 400A, it requires signatures for leave approval, making sure the request meets organizational policies.

  • Personnel Development Leave Form: This form is similar as it covers leave specifically for professional development. Both require justification for leave and include approval processes from supervisors.

  • Military Leave Request: This document is for employees requesting leave for military service. It parallels the OHR 400A in data collection about the employee’s situation and required levels of approval.

  • Vacation Leave Request Form: This form seeks approval for employees taking vacation time. It is similar to the OHR 400A, which also categorically addresses different types of leave and necessitates supervisor approval.

Dos and Don'ts

When completing the OHR 400A form, it is essential to follow certain guidelines to ensure that your leave request is processed smoothly. Here are seven important tips to consider:

  • Double-check all personal information. Make sure your name, Social Security number, and contact details are correct. Incorrect information can cause delays.
  • Clearly specify the type of leave requested. Indicate whether you are seeking leave with pay or without pay, and ensure you fill out the correct leave code.
  • Attach necessary documentation. For sick leave, include a doctor’s note if required. If applying for military leave, attach a copy of your military orders.
  • Keep copies of the form. Before submitting the form, make photocopies for your records. This will help if you need to refer to the application later.
  • Do not submit incomplete applications. Ensure all sections of the form are filled out completely; missing information can lead to rejection.
  • Do not forget to sign and date the form. An unsiged form is considered invalid and may not be processed.
  • Ensure you understand the approval process. Know who needs to approve your leave request, whether it’s just your supervisor or requires additional approvals.

Following these guidelines can help navigate the leave application process more effectively. Stay organized, and reach out for assistance if needed. Using careful attention to detail will increase the chances that your request is handled promptly and efficiently.

Misconceptions

Understanding the OHR 400A form can be tricky, especially with the many misconceptions surrounding it. Here’s a clear look at some common misunderstandings to help clarify your thoughts.

  • It's only for illness-related leave. Many people think the form is only for sick leave. In reality, it covers multiple types of leave, such as vacation, personal, and family leave.
  • I don’t need a doctor’s note for any sick leave. This isn’t true. You may need a doctor's statement if your sick leave extends beyond five consecutive days to justify the time away.
  • Approval for leave is guaranteed once submitted. Unfortunately, this is not the case. Leave requests can be denied for various reasons, including insufficient leave credits or lack of proper documentation.
  • I can submit the form anytime without a deadline. There are timeframes for submitting leave requests. Depending on your situation, there are guidelines for when forms must be submitted to ensure proper approval.
  • Leave without pay is always detrimental. Some might think that taking leave without pay is a negative choice. However, in certain situations, it can be a beneficial option, especially if you need to maintain your job security during extended absences.
  • My request for military leave is different from other leaves. While there are specifics involved in military leave, it still follows the same process of submission and approval through the OHR 400A form.
  • Only my principal needs to sign off on leave requests. For some leave types, especially family, military, and political leave, a higher-level approval is also necessary beyond just your immediate supervisor.
  • I can just fill out the form quickly and submit it. Rushing through the completion of the OHR 400A isn’t advisable. Take your time to ensure all required sections and supporting documents are properly filled out and attached for a smooth approval process.
  • Once I submit the form, I don't need to follow up. Following up is important. After submitting your request, checking in can help avoid any delays in processing your application and ensure all required information is received.

Addressing these misconceptions can make the leave application process smoother and more efficient. Always refer back to the most current guidelines for the OHR 400A form to stay informed.

Key takeaways

Filling out the OHR 400A form requires attention to detail to ensure a smooth leave request process. Here are some key takeaways:

  • The form must be completed accurately and thoroughly, including personal information and the type of leave requested.
  • Supporting documents are necessary based on the type of leave, such as a doctor's note for sick leave lasting more than five days or military orders for military leave.
  • Always obtain the required approvals. The Principal or Immediate Supervisor must sign off for sick, vacation, and personal leave, while additional approval from the PRO/CAS is needed for family, military, personnel development, and political leave.
  • There is a distinction between leave with pay and leave without pay; be clear about the leave being requested and ensure correct processing by providing the form to the correct office.