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Time Off Request Form
1
Employee Name
First Name
Middle Name
Last Name
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2
Start Date
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Month
Day
Year
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3
End Date
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Month
Day
Year
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4
Start to work on
-
Month
Day
Year
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5
Reason
Please Select
Vacation
Personal Leave
Sick
Other
Please Select
Please Select
Vacation
Personal Leave
Sick
Other
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6
Additional Comments
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