The NYC DOE PD-19 form, formally the Application for Excuse of Absence with Pay for Administrative Employees, is what you file to get paid time off for qualifying events like jury duty, bereavement, a subpoena, quarantine, a civil service exam, military duty, graduation, cancer screening, or a workers’ compensation hearing. You check the box for your reason, fill in the dates and details, attach the documentation that reason requires, and hand it to your supervisor for approval. A blank copy is on the DOE’s InfoHub under the excused absence section for administrative employees.
Who the Form Is For
PD-19 is for NYC DOE administrative employees and civil service title holders, including nurses and therapists. Pedagogical staff such as teachers and school counselors use different forms. It is also meant for short, specific absences. If you need extended time for child care, personal affairs, restoration of health, paid family leave, or paid parental leave, those go through the Self-Service Online Leave Application System (SOLAS), and FMLA requests go through the HR Connect portal.1NYC Public Schools. Leaves of Absence Voting leave has its own form, submitted to your supervisor at least two but no more than ten working days before the election.2NYC Public Schools. Excused Absence
When PD-19 does apply, the time generally is not charged against your annual leave, compensatory time, or sick leave balance, provided you submit the correct documentation and your division head approves.2NYC Public Schools. Excused Absence Your division head can also ask for more documentation than the baseline list below.
Reasons the Form Covers and How Much Time Each Allows
Jury Duty
You are excused for hours spent at court plus reasonable travel time. On days the court grants an adjournment, you are expected back at work. Attach official court documentation certifying your dates of service.2NYC Public Schools. Excused Absence
Bereavement and Funerals
There are three tiers:
- Up to four workdays for the death of an immediate family or household member. Immediate family includes a parent, child, sibling, grandparent, grandchild, spouse, parent of a spouse, or registered domestic partner, plus any relative living in your household. One additional travel day may be approved when the funeral is at a location remote from New York City; that travel day must fall on a working day within five business days or seven calendar days of the funeral, and it is the specific trigger for filing a PD-19.
- Up to one day for a relative outside the immediate family, such as in-laws, nieces, nephews, aunts, and uncles not living in your household.
- Up to four hours to attend the funeral of a co-worker or associate employee in a representative capacity. Supervisor approval alone serves as documentation.
Employees represented by the UFT, CSA, or on the Management Pay Plan can delay bereavement leave and take it any time within three calendar months of the death, as long as it is connected to a funeral or memorial service. Supervisors may request additional documentation when leave is delayed.2NYC Public Schools. Excused Absence
Court Attendance Under Subpoena
Attach a copy of the subpoena. Your supervisor’s signature on the PD-19 also serves as their statement that they have seen the subpoena and that neither you nor anyone related to you has a financial interest in the case.2NYC Public Schools. Excused Absence
Quarantine
Attach a doctor’s note that includes the quarantine dates. During a pandemic the Division of Human Resources issues separate guidance and timekeeping codes, so do not file a PD-19 for quarantine in that situation without direction from your HR director.2NYC Public Schools. Excused Absence
Civil Service Examinations
Give prior notice, then attach documentation from the administering agency showing the exam title, the date and time, and the time you were released. Written, performance, medical, and physical exams are all covered, as are related investigations and interviews.2NYC Public Schools. Excused Absence
Military or Naval Duty
Up to 22 workdays or 30 calendar days of excused absence per calendar year. Attach your certificate of attendance, drill schedule, or military orders from your commanding officer, and note on the form how many workdays you have already served in the current calendar year.
Workers’ Compensation
Covers the first week of absence from a workplace injury under the Workers’ Compensation Law, plus up to three hours for a related hearing. Attach a copy of the C-2 form or verification of hearing attendance.
Graduation
Up to one day. State the exact time of the exercises and attach the graduation announcement or program listing graduates, date, time, and degree.2NYC Public Schools. Excused Absence
Cancer Screening
Up to four hours per year. Request it in advance in writing and get approval from your office or division head before the appointment.2NYC Public Schools. Excused Absence
Other Authorized Absences
A catch-all for Selective Service appearances, blood donation, conferences and workshops, and appearances before a legislative body. Attach appropriate documentation and explain the reason in the space provided. The Division of Human Resources can approve other legitimate purposes with proper documentation.
Filling Out the Form
The PD-19 is a single page with two sections. Section one is personal and employment information: your full name, home address, current title, assigned work location, school code, district number, and seven-digit DOE Employee ID.3NYC Public Schools. HR Checklist for New Pedagogical Employees Confirm these against Employee Self-Service before you write them down. Small mismatches with payroll records slow processing.
In section two, check the numbered box for your reason and fill in the dates of the absence. Most categories want a short written detail underneath. For bereavement, write the name and relationship of the deceased, the date of death, and the funeral date. For court attendance, describe the nature of the action. For military duty, note how many workdays you have served so far in the calendar year. Then sign, and get your supervisor’s signature.
Documentation Checklist
- Jury duty: official court documentation certifying service dates.
- Bereavement travel day: documentation supporting the remote location of the funeral.
- Court attendance: copy of the subpoena or court order.
- Quarantine: doctor’s note with the quarantine dates.
- Civil service exam: agency documentation with exam title, date, time, and release time.
- Graduation: the announcement or program.
- Military duty: certificate of attendance, drill schedule, or military orders.
- Workers’ compensation: C-2 form or hearing verification.
- Selective Service: documentation with date and arrival/departure time.
Keep copies of everything. Your division head may request more.2NYC Public Schools. Excused Absence
How and When to Submit
The completed PD-19 goes to your immediate supervisor for approval. For most categories, that approval is enough. The HR Connect web portal provides downloadable HR forms and lets you upload supporting documents for various HR transactions, so ask your supervisor or HR director whether your office accepts digital submission there or wants a paper copy with original signatures.4NYC Public Schools. HR Connect Portal
File as close to the absence as possible. For planned events like a graduation or scheduled military service, submit in advance so your division can arrange coverage. For unplanned ones like jury duty or a sudden bereavement, submit the form with the documentation as soon as you return.
Mistakes That Get the Form Kicked Back
The most common problem is a missing attachment. A jury duty PD-19 without the court’s certification, or a bereavement travel request without documentation of the remote funeral location, will sit unprocessed until you provide what the category requires. Match every checked box to its documentation.
The second is mismatched employee information. If your name, school code, or district number does not match payroll, the form can be flagged. Check Employee Self-Service first.
The third is using the wrong form. Personal illness, extended leaves, FMLA, and voting leave each have their own processes. Filing a PD-19 for any of those will not preserve your excused absence status and can create payroll problems that take time to untangle.