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COVID-19 Supplemental Leave (SB95) Request Form
This form is used to request COVID-19 Supplemental Leave, per SB95 for payroll purposes. COVID-19
Supplemental Leave is available from January 1, 2021,
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How to fill out covid-19 supplemental leave reporting

How to fill out covid-19 supplemental leave reporting
01
Access the covid-19 supplemental leave reporting form provided by your employer.
02
Fill out your personal information including name, employee ID, and contact information.
03
Specify the dates for which you are requesting leave due to covid-19.
04
Provide details on the reason for requesting covid-19 supplemental leave.
05
Submit the completed form to the appropriate HR or supervisor for approval.
Who needs covid-19 supplemental leave reporting?
01
Employees who have been impacted by covid-19 and need to take leave from work to recover or care for a family member.
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What is covid-19 supplemental leave reporting?
Covid-19 supplemental leave reporting is a way for employers to track and report the use of supplemental leave taken by employees during the covid-19 pandemic.
Who is required to file covid-19 supplemental leave reporting?
Employers are required to file covid-19 supplemental leave reporting for their employees.
How to fill out covid-19 supplemental leave reporting?
Employers can fill out covid-19 supplemental leave reporting by providing information about the employee, the dates of leave taken, and the reason for the leave.
What is the purpose of covid-19 supplemental leave reporting?
The purpose of covid-19 supplemental leave reporting is to ensure transparency and accountability in the use of supplemental leave during the pandemic.
What information must be reported on covid-19 supplemental leave reporting?
Information to be reported on covid-19 supplemental leave reporting includes the employee's name, employee ID, dates of leave taken, and reason for leave.
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