Time Off Request Form printable pdf download

Time Off Request Form

TIME OFF REQUEST FORM

EMPLOYEE INFORMATION

NAME:__________________________________________

POSITION:____________________

NUMBER OF WORK DAYS REQUESTED____________

Paid

Unpaid

STARTING ON:__________________________

TO:

_____________________________

I WILL RETURN TO WORK ON:_______________________________

LOCATION:

PORT ST. LUCIE EAST

PALM BEACH GARDENS

PORT ST. LUCIE WEST

BOYNTON/DELRAY

JUPITER

AVENTURA

TYPE OF REQUEST

VACATION

FAMILY & MEDICAL LEAVE

SICK TIME

JURY DUTY

PERSONAL LEAVE

TIME OFF TO VOTE

COMMENTS

________________________________________________________________________________________

EMPLOYEE CERTIFICATION

I UNDERSTAND THAT TIME AWAY FROM WORK IS SUBJECT TO MANAGEMENT

APPROVAL AND COMPANY POLICIES

EMPLOYEE NAME:_______________________________

DATE:_________________

APPROVAL

APPROVED

REJECTED

SUPERVISOR/MANAGER APPROVAL:___________________________

DATE:___________________

Time Off Request Form