Personal Time Off Form

English

Personal Time Off Form

Employee Name

Employee Phone Number

Zone Manager/ Supervisor Name

Dock Manager Name

Casino Location

Choose which action applies

Additional Comments

Number of Days Requested/ Called In

Select Days of Absence

1. Select a date of absense

2. Select a date of absense

3. Select a date of absense

4. Select a date of absense

5. Select a date of absense

6. Select a date of absense

7. Select a date of absense

Select Days of Absence

Date I will return to work:

I elect to use my Paid Time Off hours:

Use Paid Time Off

Yes

EMPLOYEE ACKNOWLEDGEMENT:

By signing below, I acknowledge that time away from work is subject to Management’s advance approval. I understand that it is my responsibility to keep track of my available Paid Time Off hours and that if for any reason I am paid for hours that were not available to me, the over payment will be deducted from my pay.

Your Signature

Thanks for submitting!

RENUoil of America, Inc.

TM

Personal Time Off Form

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