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Time Off Request Form

TIME OFF REQUEST FORM

First name*

Last name*

Start Date*

End Date*

Time Off Duration*

ALL DAY

PARTIAL DAY

Date/Times Comments

Reason For Time Off*

Comments or Notes

Signature*

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Today's Date

If You Do Not Hear From Your Supervisor About This Request

Within 24-48 Hours

Please Contact Them Directly

THIS SECTION:

FOR OFFICE USE ONLY

APPROVED ______________________________ DATE _____/_____/_____

DENIED ______________________________ DATE _____/_____/_____

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