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Fillable Request for Leave or Approved Absence - census

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Request for Leave or Approved Absence 1. Name (Last, first, middle) 3. Organization 2. Employee or Social Security Number 4. Check appropriate box(es) and enter date and time below) Type of Leave/Absence Date From To From 5. Time To Family and Medical Leave Accrued annual leave Restored annual leave Advance annual leave Accrued sick leave Advance sick leave Purpose: Illness/injury/incapacitation of requesting...
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