Vacation / Time Off Request Form
Vacation / Time Off Request Form
TO BE COMPLETED BY EMPLOYEE:
Name____________________________ ID Number______________________
Date of Request____________________
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VACATION TIME: must be submitted to your supervisor at least 5 business days prior to requested days
Start Date____________________________ End Date_____________________________
Number of Days_______________________
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PERSONAL DAY:
Date___________________________
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ARRIVE LATE – LEAVE EARLY: must be submitted to HR at least 2 working days prior to request
Date___________________________
If late arrival, arrival time______________ If leaving early, leave time__________________
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APPROVED DAY OFF: for employees with no vacation time, must be submitted to HR
Start Date____________________________ End Date______________________________
Number of Days________________________
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TO BE COMPLETED BY SUPERVISOR OR HR: Date Received Stamp:
Comments:
______________________________________________________________________
____________________________________ _________________________________
Supervisor/HR Signature Date
Note: Submission of request does not guarantee approval. Document must be completed and signed by your supervisor. Copy to be provided to you upon request.
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