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Employee Leave Form

1 Employee Leave form Employee Information Employee Name: Submission Date: Department Supervisor: Pay Frequency: Monthly Bi-Weekly Leave Information Type of Leave Requested Hours Taken Leave Dates Annual Leave Sick Funeral Leave Personal Days (AFSCME Employees) Administrative Leave Compensation Leave Without Pay (LWOP) Court Leave FMLA Hours ( Employee taking FMLA hours must submit their Leave forms directly to Human Resources, after obtaining the supervisory signature.) FMLA Leave Choose Leave balance FML should be deducted from: Sick Annual LWOP Personal Days (AFSCME Employees) Signatures Employee Signature Date Immediate Supervisor: Approved Denied Immediate Supervisor Date 2 Employee Leave form Annual Leave : Annual Leave refers to vacation time.

2 Employee Leave Form Annual Leave: Annual Leave refers to vacation time. Vacation is defined as leisure time away from work devoted to , rest

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