Polk County Iowa Human Resources

Donated Leave Forms and Information

Donated Leave Overview and Basic Information

Donating Time

To donate a total of 8 hours of vacation/and or personal time, please click on the employee's name to access their donation form. Once you have printed and filled out the form, inter-office mail to Frank Marasco at Human Resources.

Applying for Donated Leave

The forms below are required to apply for donated leave. To apply, follow these instructions:

  • Download and print the Application for Donated Leave, the Medical and Hospital Report, and the Letter of Application.
  • Fill out the Application for Donated Leave.
  • Take the Medical and Hospital Report to your doctor to be filled out.
  • Fill out the Letter of Application.
  • Send (inter-office) the Application for Donated Leave, Medical and Hospital Report, and Letter of Application to Lola Evans at Human Resources for approval.

Upon Approval for Donated Leave

Once you have heard back from Lola Evans that you have been approved for donated leave, follow these instructions:

  • Download and fill out the Letter For Time.
  • Send (inter-office) to Frank Marasco at Human Resources.

Contact Us

Polk County Administrative Building
111 Court Ave, Suite 390
Des Moines, IA 50309

Phone: (515) 286-3200
Fax: (515) 286-3316
Dept. Hours: 8am- 5pm, Mon.-Fri.

humanres@polkcountyiowa.gov

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