"Time off Request Form"

What Is a Time Off Request Form?

A Time Off Request Form is a document that should be filled in by a worker and submitted to their employer to request time off for a specific period. Employees are required to submit this document in writing at least four weeks in advance unless the absence is caused by an emergency. Employers have the right to approve or disapprove Time Off Requests, and they usually consider the request for time off on those who have submitted it earlier than other workers. A printable Time Off Request template can be downloaded below.

A worker may submit a paid or unpaid request. An employer may confirm an unpaid request according to the requirements established by state law and provide a paid leave if it is allowed by the company's policy. A worker can find this regulation in the handbook of their employer or in their employment contract. For this purpose, an employee should complete a paid Time Off Request Form.

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How to Request Time Off From Work?

This form usually consists of three parts: the first part should be completed by the worker, the second one is for their supervisor or manager, and the third one is for office use only. A Time Off Request Form must be filled in as follows:

  1. Input information about the worker. The applicant should enter their name, address, phone number, department, and position in the organization.
  2. Enter the submission date and the name of the supervisor.
  3. Provide the reason for the absence. Attach any additional documentation or provide an explanation if it is necessary.
  4. The applicant should specify the requested dates of their absence. Enter the starting date and the date of the back to work, and the total number of days and hours required.
  5. Indicate the request type: vacation, medical reason, personal leave, family reason, military service, participation in voting, maternity leave, or volunteer time off. If an employee wishes to obtain time off for a vacation, they may fill in a Vacation Request Form, specially designed for this purpose.
  6. The applicant should provide information about the person who will cover their duties during the requested absence. Describe in details duties performed and specify any additional responsibilities that should be realized while off.
  7. The employee must sign the form and enter the date of completion.

The form may also include these additional statements:

  • The employee certifies their understanding that this request is subject to approval by their employer;
  • The employer will grant a planned time off if the worker completes all reports and paperwork and makes any necessary arrangements before the date of leave;
  • The employer will approve the requested time off if the employee submits a request before a set number of months or weeks before the expected date of absence.

A Time Off Request Form usually contains a space for the decision of the supervisor or the authorized officer. They should indicate their solution regarding this request: specify if it is approved or denied. In the case of disapproval, the supervisor has to explain their decision. This person may also decide that this request is a modified approval and indicate how it was changed. This individual should sign the form and enter the date of completion. The company may require the employee to sign under the taken decision.

A Time Off Request may also include a space for office use only, where the reason for the absence should be indicated, along with its dates, and specified if it is time off with or without pay. This section may also include the number of hours or days of time off, earned and taken by this employee. Indicate the balance due that reflects the number of hours or days available to this worker.


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Time Off Request Form
____________________________
____________________________
Today’s Date
Employee’s Name
Time-off request for:
☐ ______________________ Days
☐ ____________________
Hours
Beginning on: ____ ____ _______
Ending on: ____ ____ ________
M M
DD
YYYY
M M
DD
YYYY
Reason for Request
☐ Vacation;
☐ Family Reasons;
☐ Personal Leave;
☐ Medical Leave;
☐ Funeral/Bereavement;
☐ To Vote;
☐ Jury Duty;
☐ Other: ____________________.
I understand that this request is subject to approval by my employer.
____________________________
____________________________
Employee’s Signature
Date
Employer’s Decision
☐ Approved
☐ Rejected
____________________________
Employer’s Name
____________________________
Employer’s Signature
____________________________
Date
© ​
T EMPLATEROLLER.COM
Time Off Request Form
____________________________
____________________________
Today’s Date
Employee’s Name
Time-off request for:
☐ ______________________ Days
☐ ____________________
Hours
Beginning on: ____ ____ _______
Ending on: ____ ____ ________
M M
DD
YYYY
M M
DD
YYYY
Reason for Request
☐ Vacation;
☐ Family Reasons;
☐ Personal Leave;
☐ Medical Leave;
☐ Funeral/Bereavement;
☐ To Vote;
☐ Jury Duty;
☐ Other: ____________________.
I understand that this request is subject to approval by my employer.
____________________________
____________________________
Employee’s Signature
Date
Employer’s Decision
☐ Approved
☐ Rejected
____________________________
Employer’s Name
____________________________
Employer’s Signature
____________________________
Date
© ​
T EMPLATEROLLER.COM
© ​
T EMPLATEROLLER.COM
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