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PTO Donation Form Template

Create a supportive PTO donation system with ease

When an employee faces personal or medical challenges, your support can make a world of difference. This PTO donation form template empowers you to help colleagues by facilitating the donation of accrued paid time off. With this template, you can streamline the process of giving PTO, encourage a culture of care, maintain clear records, and ensure a quick response to requests-all while following WCAG-aligned standards. Discover how easy it is to create a supportive and compassionate workplace environment.

Use this Template (FREE) Live Preview
Your full name
Work email
Phone number
Employee ID
Department
Are you donating to a specific employee?
Yes
No
Number of PTO hours to donate (enter whole hours)
Effective date for the PTO transfer
Estimated remaining PTO hours after this donation
Type of PTO being donated
PTO (general)
Vacation
Sick leave
Personal leave
Other
Please Specify:
Recipient full name
Recipient employee ID
Reason or note for this donation (optional)
I have reviewed the company PTO donation program policy
Yes
No
I confirm I meet all eligibility and minimum balance requirements
Yes
No
I understand this donation is voluntary and cannot be reversed once processed
Yes
No
Message to HR/Payroll (optional)
I authorize HR/Payroll to process this PTO transfer
Yes
No
Type your full legal name to sign
Signature date
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Paper art illustration depicting a PTO donation form template design for FormCreatorAI article

When to use this form

This form helps you donate PTO hours to a coworker during a hardship or to a shared pool, according to company policy. Use it when a teammate faces a serious illness, new child, or deployment. For example, a colleague recovering from surgery needs extra time; a team member on active duty requires support; or a new parent needs time to bond. HR and payroll get a clear, trackable request, so hours move quickly and correctly. You document your intent, confirm your balance, and set an effective date. If the recipient has already filed a Parental leave request form or a Military leave form, referencing that helps speed review.

Must Ask PTO Donation Questions

  1. Who is the recipient (employee or donation pool)?

    This identifies exactly who will receive the hours and prevents misapplied transfers. It also confirms whether your program requires giving to a named coworker or a central pool.

  2. How many PTO hours are you donating?

    A precise number lets HR transfer the correct amount and check min/max limits. If you meant to take time off instead, submit the Leave request form.

  3. What is your current PTO balance?

    Your balance shows you have enough hours to give and will not fall below policy minimums. Payroll uses it to verify eligibility before processing.

  4. What is the reason for the recipient's need?

    Stating the reason (medical, parental, military, or emergency) helps HR confirm the donation meets program rules and prioritize urgent cases. For medical needs, referencing the Sickness leave form can support the request.

  5. Has your manager approved this donation?

    Manager approval validates staffing coverage and department compliance. It also creates an audit trail if schedules change later.

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