Form 56 - Request For Leave
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1Reset Form
Date (month, day, year)
REQUEST FOR LEAVE
State Form 56 (R6 / 7-06)
1. This leave request form is available for internal use by state agencies.
INFORMATION:
2. This form can be obtained from the Central Printing Services or online at the State Forms Catalog.
Name of employee
Title
Signature of employee
Division or location
Type of leave requested
Other _______________________________________
Vacation
Military
Family Leave
Personal
Sick
Compensatory Time-off
Dates requested
Requested leave hours
Start time of
End time of
Balance of hours after this
AM
AM
absence
absence
request
From
through
PM
PM
Comments
Signature of supervisor
Date
Signature of approving authority
Date
Approved
Approved
Denied
Denied
DISTRIBUTION: White - Approving Authority; Canary - Supervisor;
Pink - Employee
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Parent category: Legal