Employee Leave Request Form Template – Vacation, Sick, Personal, Bereavement & Unpaid Time Off HR Form | PDF and Word

Simplify employee time-off requests and maintain organized absence records with this professional Employee Leave Request Form Template.
Designed for HR departments, managers, supervisors, business owners, and small businesses, this customizable form gives employees a structured way to formally request time away from work while providing management with dedicated sections to approve, deny, and document the request.

The form accommodates multiple types of leave, including vacation, personal leave, sick leave, bereavement, jury or court duty, unpaid leave, and other absences.

WHAT’S INCLUDED
This Request for Leave Form includes:
• Employee Name
• Company Name
• Department
• Job Title
• Leave Start Date
• Leave End Date
• Return-to-Work Date
• Total Amount of Leave Requested
• Number of Hours or Days
• Leave Type Selection
• Reason for Leave
• Employee Acknowledgment
• Employee Signature & Date
• Manager Approval / Denial
• Paid vs. Unpaid Leave Designation
• Payroll Processing Information
• Manager Signature & Date

MULTIPLE LEAVE TYPES
Employees can easily identify the type of absence they are requesting.
The template includes selections for:

✓ Vacation
✓ Personal Leave
✓ Sick Leave
✓ Bereavement Leave
✓ Jury / Court Duty
✓ Unpaid Leave of Absence
✓ Other Leave

The form also references FMLA and additional documentation; however, it specifically states that it is not intended to serve as the applicable FMLA/MFL eligible leave-request form.

LEAVE DATES & TIME REQUESTED
Keep accurate records of when employees expect to be away from work.
The template provides fields for documenting:

• Leave Start Date
• Leave End Date
• Return-to-Work Date
• Number of Hours or Days Requested
• Total Amount of Leave Requested

REASON FOR LEAVE
A dedicated section allows the employee to provide a reason for the requested absence when appropriate.
Employers should customize how this section is used to avoid requesting unnecessary medical or other legally protected information.

EMPLOYEE ACKNOWLEDGMENT
Create clear documentation of your organization's leave-request procedures.
The included acknowledgment addresses:

• Written Requests for Planned Leave
• Advance Notice Expectations
• Manager Approval
• Company Leave Policies
• Business Needs
• Written Approval Requirements
• Return-to-Work Expectations
• Leave Pay Eligibility

The current template states that planned leave requests should generally be submitted at least two weeks in advance or as otherwise required by applicable law or company policy.

MANAGER APPROVAL OR DENIAL
Give supervisors a clear way to document their decision.
The manager section provides options to indicate whether the leave request is:

✓ Approved as Requested
✓ Not Approved

A dedicated manager signature and date field provides additional documentation of the decision.

PAID & UNPAID LEAVE DOCUMENTATION
The template also includes administrative options for documenting whether:
• Leave Is Paid
• Leave Is Not Paid
• Payment Occurs on the Regular Payday
• Payment Is Made in Advance
• Other Payment Arrangements Apply

PERFECT FOR
• Small Businesses
• HR Departments
• Human Resources Managers
• Business Owners
• Office Managers
• Supervisors
• Department Managers
• Corporate HR Teams
• Employee Personnel Records
• Employee Time-Off Management
• Vacation Requests
• Sick Leave Requests
• Personal Leave Requests
• Bereavement Leave
• Jury Duty Requests
• Unpaid Leave Requests
USE THIS TEMPLATE TO
• Standardize Employee Leave Requests
• Document Requested Time Off
• Track Leave Start & End Dates
• Record Return-to-Work Dates
• Document Manager Decisions
• Maintain Employee Leave Records
• Communicate Leave Procedures
• Identify Paid or Unpaid Leave
• Improve HR Recordkeeping
• Support Consistent Absence Management
CUSTOMIZABLE FOR YOUR BUSINESS
Personalize the form with your:
• Company Name
• Leave Categories
• Notice Requirements
• Approval Procedures
• Paid Time Off Policies
• Payroll Procedures
• Employee Acknowledgment Language
• Manager Approval Process
• Company-Specific Leave Policies

DIGITAL DOWNLOAD
This is a digital product. No physical item will be shipped.
Your purchase includes an editable Request for Leave Form in PDF and Word formats.

Download the files, customize the form to reflect your organization's leave policies, and incorporate it into your employee time-off and HR documentation process.

IMPORTANT EMPLOYMENT & FMLA DISCLAIMER
This template is provided for general administrative and HR documentation purposes only. It does not constitute legal, employment, labor, payroll, FMLA, disability, or human resources advice.
Use of this template does not guarantee compliance with federal, state, or local leave laws. Certain employee absences may be protected regardless of an employer's ordinary approval procedures or advance-notice requirements.

The uploaded form itself states that it is not the designated form for FMLA/MFL eligible leave requests, even though FMLA appears among the leave-type options. Businesses should review and customize this section before use.

The template also contains predetermined language regarding disciplinary action and potential job abandonment for failure to return or make contact. These provisions should be reviewed carefully and customized to the employer's policies and applicable laws before implementation.

Employers should separately evaluate applicable requirements involving FMLA, ADA accommodations, pregnancy-related leave, paid sick leave, military leave, jury duty, workers' compensation, state or local protected leave, and other legally protected absences.

Due to the nature of digital products, all sales are final.