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PTO PAY REQUEST WITHOUT TIME OFF
To be filled out by Supervisor or Manager ONLY
PTO Policy can be found in the Employee Handbook
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* Indicates required question
Employee Name
*
Your answer
Department Code
*
Your answer
Date of Request
*
MM
/
DD
/
YYYY
How Many PTO Hours Requested?
*
Your answer
How Many Hours Worked Per Week?
*
Your answer
Supervisor or Manager
*
Your Name
Your answer
Supervisor's Email Address
*
Your email Address. You will receive a copy of this request
Your answer
Manager's Email Address
*
Manager will receive a copy of this request. Separate multiple email addresses by a coma and a space.
Your answer
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