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Request for Leave-City Clerk

Please correct the field(s) marked in red below:

If leave is expected to last more than one day, an employee must submit a leave request to his or her department head at least two weeks in advance of the requested leave.

1

Request for Leave

 *
Request for Leave
2

Reason for leave.

 *
3

Is this a request for leave under the Family Medical Leave Act?

Is this a request for leave under the Family Medical Leave Act?
4

I certify that the information set forth above is true and correct.

 *

Routing information:

This request is automatically routed to your supervisor. If your supervisor approves the request, he or she must send you notice of the approval, along with copy to your department head and to the finance department. If your supervisor disapproves, he or she will send you notice of the denial.

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