Transcription of HENRY COUNTY REQUEST FOR LEAVE FORM - …
1 HENRY COUNTY REQUEST FOR LEAVE FORMPLEASE SUBMIT ALL REQUESTS FOR LEAVE (FIVE DAYS OR MORE), AT LEAST TWO WEEKS IN DateLast NameFirst NameMIType of LEAVE [From] Dates [To] [From] Times [To]Hours RequestedExplanation for time other than Annual LEAVE or for Emergency Annual LEAVE Approved by Approved DateDepartment Head or Constitutional Officer SignatureVerified byVerified DatePayroll PersonnelFill in for partial days only. Minutes should be in quarter hour SignatureDeputy Manager or COUNTY Manager Signature (If applicable) REQUEST for LEAVE form Rev Fill Out OnLine Then byFill out this form then printFMLAALL REQUESTS FOR LEAVE (LESS THAN FIVE DAYS) MUST BE SUBMITTED AT LEAST 72 HOURS IN ADVANCE.
2 (EXCEPT IN THE CASE OF AN EMERGENCY)
