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copy of this form for your records. ____________________________________ Signature of Employer _________________________________ Printed Name of Employer ____________________________ Date ____________________ Employee: Please keep a ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________ Date _______________________ Printed Name of Employee ___________________________ This Employee Request for Leave of Absence has been Approved Denied for the following reasons: __________ ______________________________________________________________________________ ______________________________________________________________________________ Signature of Employee _________ment, requests the following leave of absence dates: ______________________________________________________________________________ ____________________________________________________________________f the use of these materials. An attorney should be consulted for all serious legal matters. Employee Request for Leave of Absence Form The undersigned employee, under the terms of his or her employ, data, or profits; or business interruption) however caused and on any theory of liability, whether in contract, strict liability, or tort (including negligence or otherwise) arising in any way out oms, be responsible or liable for any direct, indirect, incidental, special, exemplary, or consequential damages (including, but not limited to, procurement of substitute goods or services; loss of useor your particular needs. The materials are used at your own risk. In no event will: i) FindLegalForms, Inc, its agents, partners, or affiliates, or ii) the providers, authors or publishers of the fors of Use" found at findlegalforms.com. These materials are provided "AS-IS." We do not give any express or implied warranties of merchantability, suitability or completeness for any of the materials fo Attorney-Client relationship is created by use of these materials. FindLegalForms, Inc. does not provide legal advice. The purchase and use of these materials is subject to the "Disclaimers and Termleave is a benefit of their employment. The employee should be given a copy of this form for their own records. The original of the form should be placed in an employee's personnel file. Disclaimer NEmployee Request for Leave of Absence Form Provided under agreement with copyright holder, © Nova Publishing Company. 2007 This form may be used by an employee to request a leave of absence, if such