Fillable Personnel-leave-request PERSONNEL LEAVE REPORT.PDF

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Personnel-leave-request PERSONNEL LEAVE REPORT.PDF

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PERSONNEL LEAVE REPORT
Employee’s Name:
Last First Middle
HR EmplID #: Department:
Request the following absence be charged to the type of leave indicated:
Date(s) of Leave:
Type of leave and number of hours to be charged:
Hours annual leave Hours authorized leave without pay
Hours employee sick leave Hours jury duty (Attach summons)
Hours military leave Hours court leave (Attach subpoena)
Hours of sick leave used for family (select one below)
Illness Accident Death
(Date)
(Relationship)
Remarks:
Employee’s Signature Date
Supervisor’s Signature Date Approval Signature Date
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Personnel-leave-request PERSONNEL LEAVE REPORT.PDF

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Completed 7 March 2020

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