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|
|
Department of Facilities
Management
|
|
Employee's Request
for Time Off
|
| |
| Employee Name _________________________________ |
| I request time off
from my regular hours of work as follows: |
| Start Date of time
off: ______________________________ |
Requested time off:
________________________________ |
| Reason: ________________________________________ |
| _______________________________________________ |
| _______________________________________________ |
| Employee's Signature:
______________________________ |
| Date
Received: ____________ Time: ____________ |
| Requested Approved:
With Pay:___________ |
| Without Pay:_______________ |
| Accumulated Overtime:
__________________ |
| Not Approved: ________________ |
| Supervisor Signature:
____________________________ |
| Date & Time: __________________________________ |
