Fillable Court Required Service Leave Request (Eastern Illinois University)

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Court Required Service Leave Request (Eastern Illinois University)

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Court Required Service
Leave Request
LEAVE FOR COURT REQUIRED SERVICE
(Jury Duty / Subpoena’s)
The University encourages and supports all of its employees in performing their civic duties. It shall be the
policy for the University to continue to pay for employees serving Jury /duty or appearing in court in response
to a Subpoena, in accordance with BOT Regulation Section II. Subsection A, c, (1), (2), & (3). Provided that
all Subpoena fees and pay for Jury Duty are turned over to the University.
Procedure:
1.
Employee must complete Court Required Service Leave form on the next page.
2.
Submit completed form along with a copy of the Subpoena or Jury Duty notice to your Department
director or designee.
3.
Department Director shall forward form to the Director of Human Resources, 2010 Old Main, for final
approval and filing.
4.
After completion of service:
a.
Deliver witness fee or Jury Duty pay to University Cashier
b.
Provide the Benefits department of Human Resources with a copy of Cashier’s receipt within
seven working days. (Also provide a court voucher verifying dates and hours served for Jury
Duty Only)
Court Required Service
Leave Request
Employee: ________________________ E-Number: ____________________
Work Department/Organization: ____________________________________
JURY DUTY:
I have been selected for _________________ Jury duty from _______________
(State/Federal) (date)
to _____________________ at ____________________.
(date) (time)
SUBPOENA:
I have been subpoenaed to report to ______________________ on ____________
(court jurisdiction) (date)
at ______________________.
(time)
ABSENCE REQUEST:
_____ I am requesting to be paid by the University for my absence and will deposit
jury duty fees/subpoena fees at the Cashier’s Office within seven days of receipt.
______________________________ ________________________________
Employee Signature Date Organization Director or Designee Signature Date
Forward to Director of Human Resources with a copy of court notice for final approval.
_____Approved _____Denied _________________________________
Director Signature/Date
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Court Required Service Leave Request (Eastern Illinois University)

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Completed 20 August 2020

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