Time Off Request
2 WEEK NOTICE IS MANDATORY. Emergencies will be handled accordingly.
Employee Name
*
First Name
Last Name
Your Personal Email for Confirmations/Approvals/Denials
*
example@example.com
Contact Number
-
Area Code
Phone Number
Start Date
*
Please select a month
January
February
March
April
May
June
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October
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December
Month
Please select a day
1
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Day
Please select a year
2026
2025
Year
End Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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Day
Please select a year
2026
2025
Year
Start to work on
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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30
31
Day
Please select a year
2026
2025
Year
Reason
*
Please Select
Company drivers only: Vacation (use vacation time if applicable)
Time off without pay.
Request off early/start late: specify time in the comments.
Additional Comments
Submit
Should be Empty: