Application For Leave - Hbt / Other Leave
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1FIRE DEPARTMENT CITY OF NEW YORK
BUREAU OF COMMUNICATIONS
FIRE DISPATCH OPERATIONS
MANHATTAN CENTRAL OFFICE
APPLICATION FOR LEAVE – HBT / OTHER LEAVE
THIS PORTION TO BE COMPLETED BY THE EMPLOYEE
I,
hereby apply for LEAVE OF
TOTAL HOURS:
Dates:
Tours or Hours:
If approved LEAVE is to be charged as follows:
HOLIDAY BANK TIME
COMPENSATORY TIME
OTHER LEAVE [Only with prior Approval of Bureau / Unit Head]
Specify:
Signature of Employee:
_________________________________
Date: ______________
ACTION BY DISPATCH OPERATIONS – HBT / OTHER LEAVES
Date: __________________
_____ Approved
_____ Disapproved By Direction of the Director – Dispatch Operations
Dispatch Operations: _______________________________
ACTION BY BOROUGH SUPERVISOR – COMPENSATORY LEAVES
Date: __________________
_____ Approved
_____ Disapproved
Signature: ___________________________ , Borough Supervisor _____________ Operations
[ BOROUGH USE ONLY]
REQUST FAXED TO DISPATCH OPERATIONS: (Date) ________________
TB 170 ADJUSTED: ___________
COPY OF REQUEST TO EMPLOYEE: __________
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Parent category: Business