Time Off Request Form

Time Off Request Form

Published on July 4th, 2023

[Your Company Name]

Time Off Request Form

Employee Information:

  • Name: _________________________________
  • Employee ID: ___________________________
  • Department: ___________________________
  • Position/Job Title: ______________________
  • Date of Request: _______________________

Type of Time Off Requested:

  • [ ] Vacation
  • [ ] Personal Day
  • [ ] Sick Leave
  • [ ] Family/Medical Leave
  • [ ] Bereavement Leave
  • [ ] Other (Please specify): ____________________

Date(s) of Requested Time Off:

From: ___________________________

To: _____________________________

Total Number of Days/Hours Requested: _____________

Reason for Time Off Request:

Manager/Supervisor Approval:

I hereby approve the requested time off for the employee mentioned above, considering operational requirements and team coverage.

Manager/Supervisor Name: _____________________

Manager/Supervisor Signature: ___________________

Date: ___________________________

Employee Acknowledgement:

I acknowledge that my time off request has been submitted and approved in accordance with the company's policies and procedures. I understand that I am responsible for ensuring proper coverage or arranging for workload distribution during my absence.

Employee Signature: ____________________________

Date: ____________________________

Please submit this form to your manager/supervisor and retain a copy for your records. Remember to follow any additional procedures or guidelines outlined by your company regarding time off requests.

Note: It is important to consult your company's specific policies and procedures regarding time off requests, including any specific forms or processes they may require. The above template serves as a general example and should be tailored to fit your company's specific needs and policies.



Pankaj Deshmukh

Pankaj Deshmukh is a digital marketing professional working with HireQuotient. He strongly believes in the never-ending process of learning and stays updated with the latest trends in order to produce valuable content.


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