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Leave Authorization Form: Use A Separate Form For Each Leave of Absence

The document is a leave authorization form for an employee named Rodney Forrest in the IT department. It shows that Rodney is requesting paid time off for vacation on September 10, 11, and 14 and September 17 of 2018. The form requires the employee and supervisor signatures to authorize the paid time off.

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Rodney Forrest
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40 views1 page

Leave Authorization Form: Use A Separate Form For Each Leave of Absence

The document is a leave authorization form for an employee named Rodney Forrest in the IT department. It shows that Rodney is requesting paid time off for vacation on September 10, 11, and 14 and September 17 of 2018. The form requires the employee and supervisor signatures to authorize the paid time off.

Uploaded by

Rodney Forrest
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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LEAVE AUTHORIZATION FORM

Use a separate form for each leave of absence.


Note: When circumstances prevent submitting this form prior to your absence, please submit it on the day of your return .
EMPLOYEE INFORMATION:

Name: Rodney Forrest Ministry/Department: IT Today’s Date: 4/25/18

NOTICE OF ABSENCE:
DATE OF ABSENCE – List each date and number of PURPOSE OF LEAVE – Please check one
hours PLEASE ROUND BY THE ½ HOUR!

Date: 9/10/2018 Hours: 8 Vacation Illness Bereavement* Personal Day Other*

Date: 9/11/2018 Hours: 8 Vacation Illness Bereavement* Personal Day Other*

Date: 9/14/2018 Hours: 8 Vacation Illness Bereavement* Personal Day Other*

Date: 9/17/2018 Hours: 8 Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

Date:       Hours:       Vacation Illness Bereavement* Personal Day Other*

AUTHORIZATION
*Please Explain Other/List Relationship for Bereavement:      

Date: 09/18/2018
Employee’s Signature:
Pay is not authorized for this
Date:       absence
Supervisor’s Signature: Pay is authorized for this absence

Last Revised 10/8/2018

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