1Compensation for Leave Cannot Exceed the Total Amount of Leave Accumulated. Should Leave

Attendance Unit

Employee’s Last Name First Name Employee ID

Date/ Time Leave Code/ Type of Leave End

Month Day Year Time Month Day Year COMPENSATORY LEAVE / EXCHANGE TIME / / : AM PM / /

Month Day Year Time Month Day Year VACATION LEAVE / / : AM PM / /

Month Day Year Time Month Day Year SICK LEAVE / / : AM PM / /

Month Day Year Time Month Day Year PERSONAL HOLIDAY / HOLIDAY / / : AM PM / /

Month Day Year Time Month Day Year LEAVE WITHOUT PAY / / : AM PM / /

Month Day Year Time Month Day Year SHARED LEAVE / OTHER / / : AM PM / / Reason For Leave (If necessary)

Minutes Tenths Minutes Tenths Minutes Tenths Minutes Tenths 1-6 .1 13-18- .3 25-30 .5 37-42 .7 7-12 .2 19-24 .4 31-36 .6 43-48 .8

Leave Not *LEAVE WITHOUT PAY Approved Authorized Absence Unauthorized Absence Comments:

Date Employee’s Name Supervisor’s Signature & Date / /

1Compensation for leave cannot exceed the total amount of leave accumulated. Should leave be approved in excess of the total accumulated, it will not be compensated. The Public Records Act, RCW 42.56.250, et. seq., requires disclosure of public records unless they are exempt. If requested, non-exempt public records in the possession of the Department of Personnel will be released. Exempt records will be withheld from public disclosure or exempt portions of records will be redacted from records prior to release.

Mil Leave Request (Rev. Oct 2013)