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Get the free Catastrophic Illness Leave Bank Request Form (CILB)

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Form GBRIB(1)1CATASTROPHIC ILLNESS LEAVE BANK REQUEST FORM (CILB) TO BE COMPLETED BY EMPLOYEE (PRINT OR TYPE) Last 4 digits of Social Security Number:Name: School/Department:Position:Telephone: Home:Cell:Date
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How to fill out catastrophic illness leave bank

01
Obtain the catastrophic illness leave bank application form from your HR department or website.
02
Carefully read the guidelines and eligibility criteria outlined in the form.
03
Fill out all personal information, including your name, employee ID, and contact details.
04
Specify the nature of your catastrophic illness and provide any necessary medical documentation.
05
Indicate the number of leave days you are requesting from the bank.
06
Get any required signatures or endorsements from your supervisor or HR.
07
Submit the completed application form along with any supporting documents to HR for approval.
08
Await confirmation from HR regarding the status of your application.

Who needs catastrophic illness leave bank?

01
Employees who are facing a serious medical condition that prevents them from working for an extended period.
02
Employees who have exhausted their regular leave entitlements and require additional leave.
03
Individuals who need time off to care for an immediate family member with a catastrophic illness.
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The catastrophic illness leave bank is a program that allows employees to donate a portion of their sick leave to a collective pool, which can be accessed by members who experience a serious health condition that warrants additional leave.
Employees who wish to access the leave from the catastrophic illness leave bank due to their own catastrophic health situation or that of an immediate family member are required to file a request.
To fill out the catastrophic illness leave bank, employees must complete a specific application form provided by their employer, detailing their personal information, the nature of the illness, and the amount of leave requested.
The purpose of the catastrophic illness leave bank is to provide financial and job protection support for employees who face prolonged medical conditions, allowing them to take necessary time off without the worry of losing income.
Information that must be reported includes the employee's identification, details of the illness (including a medical statement), the estimated duration of the leave required, and the current leave balances.
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