BEREAVEMENT LEAVE POLICY

Regular, full-time employees are eligible to receive up to [NUMBER OF DAYS OF LEAVE] [PAID/UNPAID] bereavement leave due to the death of an immediate family member. Regular, part-time employees are eligible to receive up to [NUMBER OF DAYS OF LEAVE] [PAID/UNPAID] bereavement leave due to the death of an immediate family member. For purposes of this policy, an employee’s immediate family member includes any of the following: [employee’s spouse, daughter, son, mother, father, sister, brother, aunt, uncle, niece, nephew, grandmother, grandfather, granddaughter, grandson, whether in a full, half, or step relationship, as well as daughter-in-law, son-in-law, mother-in-law, father-in- law, sister-in-law, and brother-in-law]. Where special circumstances warrant, bereavement leave for the death of other relatives may be granted with prior written approval by the [IDENTIFY APPROPRIATE OFFICIAL].

Coverage and Applicability

If an employee is off work and is receiving pay for any other form of leave, he or she is not eligible to receive additional pay or time off if bereavement leave occurs during that same period of time.

All time off in connection with the death of one of the above-listed individuals must be coordinated with the employee’s supervisor. The [IDENTIFY APPROPRIATE OFFICIAL] may approve time off due to the death of someone other than an immediate family member, or additional time off for an immediate family member. This time off would be unpaid or would require the use of [VACATION/PAID TIME OFF/ACCRUED ANNUAL LEAVE/ETC.]. An employee who abuses this policy will be subject to disciplinary action, up to and including termination of employment. If you have any questions regarding this policy or if you have questions about bereavement leave that are not addressed in this policy, please contact the [IDENTIFY APPROPRIATE OFFICIAL].

There is no accumulation of bereavement leave days and no payment upon separation from [CITY/AUTHORITY/REGIONAL COMMISSION] employment. The approved bereavement leave days may be taken [CONSECUTIVELY/NON-CONSECUTIVELY].

-3-