Revised 10/08/2009
Vacationrequestform2009.doc
Vacation Request Form
Please forward the original to the Human Resources Department at least two (2) weeks prior to the date(s)
requested. This form is for record keeping purposes.
You must obtain your supervisor’s approval prior to forwarding this request to HR.
Employee Name (print): Date:
I request time off for (check all that apply): Vacation Personal/Sick Floating Holiday
I request vacation/personal/sick/floating holiday time on the following date(s):
I will return to work on (date):
Total days to be taken: Vacation Personal/Sick Floating Holiday
Employee Signature:
Department:
Approved by:___________________________________________________________ Date:_______/________/_________
Not Approved by:_______________________________________________________ Date:_______/________/_________
Reason for Disapproval_________________________________________________________________________________
Human Resources:______________________________________________________ Date:_______/________/_________
Vacation Policy
Vacations will, as often as possible, be granted at the time most desired by the employee. When more than one employee in the same
department requests vacation at the same time, service time of the parties will generally be the determining factor.
Otsego County reserves the right to final allotment of vacation, including the right to limit the total number of employees on vacation
at any one time to ensure the orderly and efficient operation of Otsego County business.
This policy may be discontinued or amended by Otsego County at any time, effective on notice to any employee or posting in the
County building.
