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To Be Filled Out By Employee REMEMBER: All time off requests need to be submitted a MONTH in advance unless circumstances are beyond your control. Please remember to send this request to your manager, to Laura Plummer & to yourself.

  • Employee Name

  • Employee Department

  • Name of Supervisor/Manager

  • Type of Time Off Request:

  • Comments

  • Start Date of Time Off Request

  • End Date of Time Off Request

  • Employee Signature

To Be Filled Out and Approved By Management

  • Request Approval:

  • Comments

  • Supervisor/Manager Signature

Please give a copy to Laura Plummer

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.