Blank Employee Time Off Request Form

Employee Time Off Request Form
Time Off Information
Employee Name:
Employee SSN:
Department:
Client
Company
Type of Absence Requested:
Sick Vacation Bereavement Time Off Without Pay
Military Jury Duty
Family Medical
Leave (FMLA) Other
Dates of Leave From:
To:
Reason for Leave:
Your request for time off, other than sick leave, must be submitted, scheduled and approved by your manager,
two weeks prior to the first day you will be on leave.
Employee Signature
Date
Manager Approval
Approved
Rejected
Comments:
Manager Signature
Date
SHEAKLEY HR, LLC
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Blank Employee Time Off Request Form PDF

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