Request Off Form

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Request Off Form
Subject to Management Approval
Name: _______________________________
Dept: _________________ Today’s Date: ___________
Date(s) Request Off: ____________________
Requested Return Date: __________________
Reason: ______________________________________________________________________________
_____________________________________________________________________________________
Hours of Vacation Pay Requested (leave blank if none): ____________
Employee Signature: _______________________________________________
HR: _________ Y/N:_______ Reason:_______ Date:_____
Manager: _________

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