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REQUEST FOR PTO
Employee PTO Request
Michael
2018-06-11T09:21:55-05:00
Employee Name
*
First
Last
Manager
*
Select
Goslin
Is your request flexible?
*
Yes
No
Request Type
*
Single Day
Partial Day
Range of Days
Requested Date
*
MM slash DD slash YYYY
Requested Begin Time
*
:
Hours
Minutes
AM
PM
AM/PM
Requested End Time
*
:
Hours
Minutes
AM
PM
AM/PM
Requested Begin Day
*
MM slash DD slash YYYY
Requested End Day (DAY YOU RETURN TO WORK)
*
MM slash DD slash YYYY
IS THE DATE ABOVE THE ACTUAL DAY YOU WILL RETURN TO WORK?
*
Yes
ARE YOU SURE THAT THE DATE ABOVE IS THE DAY YOU WILL BE BACK AT WORK?
Yes
ARE YOU SURE THAT THE DATE ABOVE IS THE DAY YOU WILL BE BACK AT WORK?
Paid Time Off (PTO)
*
I agree:
If eligible, and wishing to use paid time off (PTO) for the requested date(s), I understand it is my responsibility to communicate with my manager at end of time period to apply any hours.
It is my responsibility to verify the agreed upon hours have been applied to my timesheet (prior to signing & submitting).
*
I agree:
It is my responsibility to verify the agreed upon hours have been applied to my timesheet (prior to signing & submitting).
Comments
Employee Signature
*
Today's Date
*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.
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