Leave Of Absence Request Form PDF Details

Have you ever needed to take a break from work, but weren't sure how to go about it? The leave of absence request form is the perfect way to let your employer know that you need some time away. In this blog post, we'll discuss the steps you need to take to fill out the form, and what to expect once you submit it. We'll also provide some tips for making your leave of absence as smooth as possible. So, whether you're planning a vacation or dealing with a personal emergency, read on for information on how to make a leave of absence request.

In the list, there's some good information concerning the leave of absence request form. You can learn its length, the actual time to fill out the form, the fields you'll have to fill in, and so forth.

QuestionAnswer
Form NameLeave of Absence Request Form
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesprintable leave of absence form, leave of absence form template, leave of absence request form template, leave of absence form sample

Form Preview Example

LEAVE OF ABSENCE REQUEST FORM

Name:________________________________ Date: ___________________

Department: _____________________

Type of Leave Requested:

Medical Leave ( ), FMLA Leave ( ), Personal Leave ( ), Other ( ) Leave Start Date: __________________Return Date: ____________________

Reason for Leave:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Read carefully the following, and initial each blank to signify understanding.

________

I understand that my leave of absence is without pay, other than authorized

 

in the Leave of Absence Policy, and that the duration of any leave is at the

 

discretion of the department head.

Medical and personal leave may not

 

exceed six months; FMLA Leave cannot exceed twelve weeks.

________

I understand that I must return to work, or request an extension, by

 

___________ or I will be deemed to have voluntarily terminated my

 

employment on that date.

 

________ I understand that I must submit

a written physician’s release to the

 

Administrative Office in order to return to work from a Medical Leave of

 

Absence.

 

________ For other than FMLA Leave, I understand that my present position may not

be available either due to a need to fill the vacancy or due to a medical

condition related to my release.

 

__________________________________

_____________

Employee Signature

Date

_________________________________

______________

Department Head

Date

_________________________________

______________

Administrative Office

Date

How to Edit Leave of Absence Request Form Online for Free

Our top computer programmers have worked together to get the PDF editor that you could benefit from. The app makes it easy to create application for leave of absence pdf documentation immediately and efficiently. This is all you need to do.

Step 1: The first step will be to click the orange "Get Form Now" button.

Step 2: Now you can change your application for leave of absence pdf. You should use our multifunctional toolbar to include, remove, and modify the content material of the form.

You should enter the following information to complete the application for leave of absence pdf PDF:

portion of empty spaces in unpaid leave of absence form

Jot down the data in I understand that I must return to, I understand that I must submit a, For other than FMLA Leave I, Employee Signature, Department Head, Administrative Office, Date, Date, and Date.

Completing unpaid leave of absence form step 2

Step 3: Select the "Done" button. Then, you may export your PDF file - save it to your electronic device or send it through electronic mail.

Step 4: It may be easier to create duplicates of the file. You can rest easy that we are not going to display or check out your data.

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Related Resources

  • Leave of Absence (LOA) - DGS.CA.gov

    Request “direct pay” forms from the Attendance Clerk to continue medical benefits and make direct payment to insurance(s) carrier(s). If requesting extension, ...

  • Formal Leave of Absence Request

    FORMAL LEAVE OF ABSENCE REQUEST. Office of Human Resources. DGS OHR 28 (Rev. 09/2019). REVIEW PAGE 2 FOR ADDITIONAL INFORMATION AND INSTRUCTIONS.

  • Request for Leave or Approved Absence - OPM

    Type of Leave/Absence ... Certification: I hereby request leave/approved absence from duty as ... if required) and that falsification on this form may.

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