HomeMy WebLinkAboutComp Time Form
Request for Use and/or Payment
of Accumulated Compensatory Time
Section 1 Î To Be Completed by Employee
To:
(Department Head Name)
From:
(Employee Name & Signature)
Date:
(Insert date of employeeÓs request)
Re: Request for of Accumulated Compensatory Time
(Specify payment or use)
I hereby request the payment and/or use of my accumulated compensatory time as follows:
1. Payment of Accumulated Compensatory Time Hours
2. Use of Accumulated Compensatory Time Hours for time off
Dates of Use Time I will Leave Time I Will Return Total Hours Used
Section 2 Î To Be Completed by Department Head
Date Received Approved: ________ Denied:
Reason for Denial:
Department Head Signature:
Section 3 Î To Be Completed by Supervisor or Designee
Date Received Approved: ________ Denied:
Reason for Denial:
Supervisor or Designee Signature: