County Of Zavala Employee Leave, Suspension Or Termination Form

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COUNTY OF ZAVALA
Dept. / Division: ______________________
Employee Leave, Suspension or Termination Form
Employee
Today’s
Name:____________________________
Date:__________
Social Security
: (Select one )
Type of Leave
Number:______________________
I am requesting the following dates off:
SUN
MON
TUE
WED
THU
FRI
SAT
Date
SUN
MON
TUE
WED
THU
FRI
SAT
Date
Notes:_____________________________________________________
__________________________________________________________
__________________________________________________________
Employee Signature:_________________________ Date: ___________
Manager’s Approval
Manager’s Signature:______________________ Date: ____________
 Approved
 Not Approved
Notes:

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