THE LONDON SCHOOL OF ECONOMICS AND POLITICAL SCIENCE
UNPAID LEAVE – Application Form
Members of academic staff may apply for unpaid leave at the discretion of their Head of Department.
IMPORTANT Please refer to section 6 regarding Superannuation and Payroll information.
The School will attempt to recover overpayments of salary that are made as a result of a failure to
complete this form and to have it returned to Human Resources at least one month before the start
of leave.
PART A.
To be completed by the MEMBER OF STAFF
1.
Name: (including title)
2.
Department/Institute:
3.
Purpose for which leave is sought:
(Please give full details including full name and address of sponsor (if any)).
4.
Availability of your room:
Room Number:
(The Estates Strategy Committee requests that notification is given when leave is taken in order to
utilise space. If there are special circumstances which you feel should be taken into account, please
give details here).
5.
DURATION OF UNPAID LEAVE
Please give the exact dates of the unpaid leave as these will be taken as the dates on which
your salary will cease and recommence to be payable by the LSE:
Start of unpaid leave: (Day/Month/Year)
End of unpaid leave: (Day/Month/Year)
May 2011
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6.
USS SUPERANNUATION CONTRIBUTIONS
1. If you are working overseas then your USS membership will be suspended for that time and
no pensionable service will accrue. Please contact Jenny Casey in Superannuation Office
(ext 7093) j.a.casey@lse.ac.uk to discuss your options. USS regulations have changed,
please visit the HR website for more details.
2. If you are going to work for a UK employer and do not wish to join their pension scheme,
you can ask your temporary employer if they are willing to pay the USS employer’s costs If
they are, then the school will invoice them for the payment during your absence and at
the same time you will be invoiced for your share of the contribution. If no contributions
are remitted to USS then your membership will be suspended until your return.
3. If you will not be employed during the period of your Unpaid Leave your membership of
USS will be suspended for the period and no service will accrue unless your Department is
willing to keep up payments on your behalf.
USS require signed forms from a member prior to their period of absence and you must
contact Jenny Casey in the Superannuation Office (ext 7093) j.a.casey@lse.ac.uk as soon as
your absence has been agreed by the School to ensure that ill-health and death in service
benefits are continued.
7.
PAYROLL INFORMATION
1. When unpaid leave is taken your salary will cease to be payable by the LSE. If you have a
salary sacrifice scheme in place you must contact the Payroll Team
(hr.pay.info@lse.ac.uk) in order to arrange your salary adjustments.
Signed...............................................................................................
Date:........................................................
THIS FORM SHOULD NOW BE SENT TO YOUR HEAD OF DEPARTMENT
May 2011
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PART B To be completed by the Head of Department
(if the Head of Department is in the final year of office, the Head of Department-elect should
complete this form.)
1.
Staff Leave
Can you guarantee that the total level of absences for all reasons during the period of this leave
in your Department/Institute will not exceed what is appropriate to its size and needs? (You are
reminded that the entitlement to Sabbatical Leave is given precedence over other types of
absence.)
YES / NO (Please delete)
2.
Replacement Teaching Cover
(a)
Please provide full details of how it is proposed that the applicant’s teaching, tutorial,
supervisory and administrative duties will be covered while he/she is on leave.
(b)
Will the cost of the replacement teaching be fully covered by the salary savings/external funds
available?
YES / NO (Please delete)
If NO, how do you propose to cover the shortfall?
3.
Benefits of Leave
Please comment on the benefits or otherwise that are likely to accrue both to the applicant and the
department if this leave is granted.
4.
Head of Department’s recommendation (Please delete as applicable)
(a)
I approve this application
(b)
I am unable to approve this application for the following reasons:
Signed:.................................................................... Date: .............................................
THIS FORM SHOULD NOW BE SENT TO THE PAY TEAM, HUMAN RESOURCES DIVISION
May 2011
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