MU PR500 Authorization

• Employee Name

Leave

• Type of leave

  Select Vacation (full day) Vacation (1/2 AM) Vacation (1/2 PM) Vacation Week Personal Holiday Comp Time Bereavement Leave

  • Vacation (full day)
  • Vacation (1/2 AM)
  • Vacation (1/2 PM)
  • Vacation Week
  • Personal Holiday
  • Comp Time
  • Bereavement Leave

• Sick Leave

  Select Employee IllnessDoctor/Dental Appointment Family or Child Illness Bereavement

  • Employee IllnessDoctor/Dental Appointment
  • Family or Child Illness
  • Bereavement

• FMLA Leave

  Select Sick Unpaid Leave Personal Holiday Vacation Comp Time

  • Sick
  • Unpaid Leave
  • Personal Holiday
  • Vacation
  • Comp Time

• Date Requested

• Work Hour Variance (must include the Days and Hours that will vary)

  Select Appointment Family Financial Legal Other

  • Appointment
  • Family
  • Financial
  • Legal
  • Other

• Signature

  Sign

Department Manager Signature

• Department Manager Signature

  Sign

• Comments: