Clone of Time-Off Request Form (Portland Security Services)

It is the policy to encourage employees to use their accrued PTO/sick time* and enjoy time away from work with their families. Every effort will be made to accommodate employee requests after considering business need and the anticipated employee scheduling needs of the Company. PTO requests will be considered on a first come, first served basis.

Where possible this form is to be fully completed no less than two weeks prior to the onset of the requested PTO unless it is an unforeseen absence due to illness, injury or request for a protected leave of absence. PTO is not to be requested, nor is it approved, by the client. FDSS reserves the right to deny any PTO request based on business need.

If time off is being requested due to a medical issue or other potential leave of absence, please review the relevant policy (Leave of Absence, FMLA, Crime Victim's Leave, Bereavement Leave, Domestic Violence Leave, Military Leave) and reach out to your Supervisor or the HR department.

If your time off request is denied (and it is not a protected leave or other exigent situation) and you choose to take the time regardless, it will be addressed with escalated disciplinary action up to and including termation.

*Certain employees have 'sick time' based on the state their employed in and/or the nature of the customer they work for.

Your Name:*

Your Email:*

example@gmail.com

Select Time-Off Reason: *

*Please consult the HR Dept regarding your leave of absence options.

Time Off Start Date: *

DateHourMinutes

Time Off End Date: *

DateHourMinutes

Additional Comment/Explanation:

Upload any supporting documentation (jury summons, doctor's notes, etc.)

Browse Files

My signature below is acknowledgement of the following:

PTO will be used until exhausted, at which time any time off will be unpaid and may subject the employee to disciplinary action for absenteeism.
I understand that I may be required to provide medical certification or other documentation to justify use of time for illness.
I certify that all statements contained in this request are true and complete.
Any oral or written statements that are false and/or misleading may be grounds for disciplinary action.

Signature

Paid Time Off (PTO) Use: (note that in certain circumstances like FMLA absences PTO use is mandatory).

Please apply all available PTO hoursI am taking this absence unpaid