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Back to Forms for 'Compensation & Benefits'.




Employee Name ________________________            Date _____________


Dates Requested From ___________________             Do _______________


Total Vacation Days Accrued        ___________


Total Vacation Days Taken           ___________


Total Vacation Days Available      ___________


Number of Days Requested          ___________


Total Vacation Days Remaining     ___________


(if request approved)



Approval: ______________________________


Manager Signature _______________________


Date __________________________________


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