Time Off Request Form

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Connecticut Distributors, Inc.
333 Lordship Boulevard, Stratford, Ct 06615-7100
telephone (203) 377-1440 | FaX (203) 377-8960
Date
TiMe off requesT forM
eMployee naMe _____________________________________________
DeparTMenT _________________________________________________
Type:
VaCatIon = V
FLoater = F
PerSonaL/SICk Day = S
eMployee
Manager

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