1100 Plum Creek Parkway, Suite 210, Castle Rock, CO, 80104
(720) 555-0129 · office@frontrange-roofing.example
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Time off request
Use this form to request time away and record the decision. Submitting a request does not itself approve the absence.
Employee name / Department / Supervisor
Space to complete on the printed formRequested start date and time / Return date and time
Space to complete on the printed formType of time off / Hours requested
Space to complete on the printed formAvailable balance, if applicable
Space to complete on the printed formReason or supporting information, if needed (do not include a medical diagnosis)
Space to complete on the printed formCoverage or handoff arrangements
Space to complete on the printed formEmployee signature / Date submitted
Space to complete on the printed formManager decision
Approved / Not approved / More information needed
Space to complete on the printed formApproved dates and hours / Paid or unpaid / Applicable policy
Space to complete on the printed formExplanation and next steps
Space to complete on the printed formManager signature / Date / Date employee notified
Space to complete on the printed form