Leave Request

Company
IN ORDER TO BE PAID FOR APPROVED LEAVE HOURS, THIS FORM MUST BE TURNED IN BEFORE THE PAYROLL DEADLINE
Employee Name
Date of Payday
MM slash DD slash YYYY

The Friday you want this included on
Number of Hours of Leave Time You Are Requesting
First Day of Leave
MM slash DD slash YYYY
Last Day of Leave
MM slash DD slash YYYY
Type of Leave
Employee Signature
Supervisor's Signature