Vacation - Time Off Request Form
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VACATION / TIME OFF REQUEST FORM (PAID OR UNPAID) Date: Employee Name: Department: Dates Requested:
From: ( First Day Off )
To: ( Last Day Off )
COMMENTS:
! ATTENTION ! This form MUST be approved by your Supervisor before given to Human Resources! OFFICE USE ONLY SUPERVISOR:
Approved
Not Approved
Comments:
Supervisor Signature:
HUMAN RESOURCE: Paid Leave Available at Time of Request?
YES
NO
Comments:
Human Res. Signature:
FINAL ROUTED TO EMPLOYEE?
POSTED TO VAC/LEAVE SCHEDULE?
24052335.xls
United Services
Revised 10/27/2009
24052335.xls
United Services
Revised 10/27/2009
From: ( First Day Off )
To: ( Last Day Off )
COMMENTS:
! ATTENTION ! This form MUST be approved by your Supervisor before given to Human Resources! OFFICE USE ONLY SUPERVISOR:
Approved
Not Approved
Comments:
Supervisor Signature:
HUMAN RESOURCE: Paid Leave Available at Time of Request?
YES
NO
Comments:
Human Res. Signature:
FINAL ROUTED TO EMPLOYEE?
POSTED TO VAC/LEAVE SCHEDULE?
24052335.xls
United Services
Revised 10/27/2009
24052335.xls
United Services
Revised 10/27/2009
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