Vacation Carryover Request Form

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VACATION CARRYOVER REQUEST
This vacation carry over request form must be completed if an employee is requesting
to carry over more than 5 vacation days.
{Insert Name of Company} vacation policy provides for carry over of vacation time of
one week when use of such time is delayed because of company need. There is an
automatic carry over of five (5) days or less of vacation time for one year. Carryover of
vacation time beyond five days requires approval by the supervisor and Human
Resources. Vacation carryover is limited to the unused vacation time accrued during the
most current year. The supervisor and human resources must approve this form.
Completed carryover request forms must be submitted to Human Resources no later
than January 5.
Employee: _____________________
Date: ________________
SS#: _________________________
Department: __________
Request for additional carry over of vacation time
_______ hours
(This number does not include the automatic carryover of 5 days)
Reason for request:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Approval:
__________________________________________
__________
Supervisor:
Date:
__________________________________________
__________
Human Resources Representative
Date:
VACATION CARRYOVER REQUEST
This vacation carry over request form must be completed if an employee is requesting
to carry over more than 5 vacation days.
{Insert Name of Company} vacation policy provides for carry over of vacation time of
one week when use of such time is delayed because of company need. There is an
automatic carry over of five (5) days or less of vacation time for one year. Carryover of
vacation time beyond five days requires approval by the supervisor and Human
Resources. Vacation carryover is limited to the unused vacation time accrued during the
most current year. The supervisor and human resources must approve this form.
Completed carryover request forms must be submitted to Human Resources no later
than January 5.
Employee: _____________________
Date: ________________
SS#: _________________________
Department: __________
Request for additional carry over of vacation time
_______ hours
(This number does not include the automatic carryover of 5 days)
Reason for request:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Approval:
__________________________________________
__________
Supervisor:
Date:
__________________________________________
__________
Human Resources Representative
Date:

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