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TIME OFF REQUEST FORM Updated 01/14/16 EMPLOYEE INFORMATION NAME TODAY S DATE DEPARTMENT DATES REQUESTED TIME OFF TOTAL NUMBER OF HOURS REQUESTED I understand that time away from work is subject to management approval. Employee Signature Date TYPE OF REQUEST VACATION MILITARY LEAVE PERSONAL LEAVE FAMILY AND MEDICAL LEAVE BEREAVEMENT LEAVE SICK TIME JURY DUTY COMPENSATORY TIME TIME OFF WITHOUT PAY PERSONAL DAY Other COMMENTS APPROVAL APPROVED YES NO Supervisor/Manager Signature Elected...

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