Time Off Request Form

Time Off Request Form
This form is a request only. Time off is not guaranteed unless approved by your manager. Please do not make travel or personal arrangements until your request has been formally approved.
Employee Name

First NameLast Name
Email to Receive Approval/Denial to
example@example.com
Department
(Warranty/Construction/Sales/Admin
Manager

First NameLast Name
Date Requested Off

MonthDayYear
Date
Date Requested to Return to Work

MonthDayYear
Date
Reason For Absence
Vacation/Family Emergency/Sick
Hours of PTO requested
Coverage Plan
Who will cover your responsibilities in your absence?
Employee Signature

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