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Get Leave Form - Tsu

Yee Identification No.: Department: Section A I request my absence be charged to (Check appropriate box): Sick Vacation Compensatory Time Military - paid up to 15 calendar days per year Jury Duty Other Leave of Absence (L) - up to 10 days NOTE: For illness of more than three (3) working days, a statement from the attending physician must be attached. Date(s) of Absence: From: To: No. of Days: Time/hours of Absence: From: To: No. of Hours: Reason for Absence: Date Employee Sig.

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