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EMPLOYEES ELECTION REGARDING UTILIZATION OF SICK AND ANNUAL LEAVE Peace Officers Employees Name: Employees SSN:___ Date of Injury: ___Agency:If you know, how many hours of leave do you have?______

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The required information must be typed.

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It depends on the specific situation and regulations in place.

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The form must be filled out accurately and completely according to the instructions provided.

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The purpose is to collect and report necessary information.

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Specific information related to the filing requirements.

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