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BEREAVEMENT REQUEST FORMName Work Site Supervisor Please PRINT neatly. I request Bereavement Leave on the following dates: ___ For the death of ___ First NameMI___Last NameDeceased Residence: ___Relationship___CityStateDate
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I request bereavement leave is a formal request made by an employee to take time off from work due to the death of a family member or loved one.
Employees who need time off due to the death of an immediate family member are typically required to file an i request bereavement leave.
To fill out an i request bereavement leave, complete the designated form provided by your employer, including details such as the deceased person's relationship to you, the date of death, and the requested dates for leave.
The purpose of i request bereavement leave is to allow employees to take necessary time off to grieve, attend funerals, or manage affairs related to the death of a loved one.
Required information may include the employee's name, the relationship to the deceased, the date of death, and the dates requested for leave.
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