Please rate Form Ad 1046
Approval as a leave recipient does not guarantee that leave will be donated.
Absent from duty: you must be absent from duty for a prolonged period of time due to your medical condition or the medical condition of your family member.
Attach: a brief description of the nature and severity of the medical emergency and appropriate documentation of the medical emergency.
Send: after completing this form, forward through your supervisor to the office in your agency designated to approve leave recipients.
Publication: you are NOT required to publicize your circumstances in order to qualify and participate in the LTP.
| Question | Answer |
|---|---|
| Form Name | Form AD-1046 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 6 min |
| Edition | Rev. 4/89 |
| Where to send | Through your supervisor to the office in your agency designated to approve leave recipients |
| Other names | AD-1046, AD 1046, AD1046, Form 1046, Leave Transfer Program Recipient Application |
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Please rate Form Ad 1046
