Northwind Partners
People & Culture
Time-Off Request
Form HR-04 · Paid & Unpaid Leave
Employee
Employee name
Employee ID
Department
Reporting manager
Leave type
Vacation
Sick
Personal
Bereavement
Unpaid
Dates requested
First day off
Last day off
Total days / hours
Return to work
Reason (optional)
Coverage arrangements — who will cover your work
Employee signature
Employee signature
Date signed
Manager approval
Approved
Denied
Manager signature
Date