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Sheet: PTO Reqst. Form

PTO (PAID TIME OFF) AND TRAVEL REQUEST FORM (V2.0) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Jan | 1 | Safi
Last Name, First Name (as shown on passport): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Team: |  |  | O & I |  |  |  |  |  | Employee #: |  |  |  |  |  |  |  |  |  | Feb | 2 | Fly Dubai
PTO Hours Accrued: |  |  |  |  |  |  | Hours requested: |  |  |  |  |  |  |  |  | Balance (end of PTO): |  |  |  |  |  |  |  |  |  |  | Passport country: |  |  |  |  |  | USA |  |  | Exp: |  |  |  |  |  |  | Mar | 3 | Ariana
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Apr | 4 | Kam Air
PTO Address: |  |  |  |  |  |  |  |  |  |  |  |  | Phone Number: |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME]: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | May | 5
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Jun | 6
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Jul | 7
[NAME]: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date of last long PTO (end date): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Aug | 8
Date of request/submission: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date of last short PTO (end date): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Sep | 9
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Oct | 10
Type of Leave (check all that apply) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Comments |  |  |  |  |  |  |  |  |  |  | Nov | 11
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | VISA expires upon return from PTO; request assistance with turn in upon arrival back in theater |  |  |  |  |  |  |  |  |  |  | Dec | 12
Long PTO: |  |  |  | Emergency: |  |  |  |  |  | Medical: |  |  |  |  |  | Resignation: |  |  |  |  |  | Holiday/Flt. Holiday: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 13
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 14
Short PTO: |  |  |  | LWOP: |  |  |  |  |  | Business: |  |  |  |  |  | Holiday: |  |  |  |  |  | Bereavement: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 15
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 16
Holidays, LWOP, [NAME] This PTO |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 17
 |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  | Hours |  | Days |  |  |  | 18
Holidays (6) |  | HOL-1: |  |  |  |  |  | HOL-2: |  |  |  |  |  | HOL-3: |  |  |  |  |  | HOL-4: |  |  |  |  |  | HOL-5: |  |  |  |  |  | [NAME]: |  |  |  |  |  |  |  |  |  |  |  | 19
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 20
Floating Holidays (4) |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  |  |  |  |  |  |  |  |  |  |  | Hours |  | Days |  |  |  | 21
 |  | FLT-1: |  |  |  |  |  | FLT-2: |  |  |  |  |  | FLT-3: |  |  |  |  |  | FLT-4: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 22
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 23
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 24
Bereavement (3) |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  | Month |  | Day |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Hours |  | Days |  |  |  | 25
 |  | BRV-1: |  |  |  |  |  | BRV-2: |  |  |  |  |  | BRV-3: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 26
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 27
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Leave             With-Out Pay                      (LWOP) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Hours |  | Days |  |  |  | 29
 |  | LWOP Start Date: |  |  |  |  |  |  |  |  |  |  |  | LWOP Finish Date: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 30
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31
Note:  Holidays and Floating Holidays can be used anytime during the calendar year; however, [NAME] are earned at the beginning of each quarter.  LWOP requested requires a reason /justification below from the employee for consideration by the approving chain.
Leave Details
Departure date: |  |  |  |  |  |  |  | Time: |  |  |  |  |  | Return Date: |  |  |  |  |  |  |  |  |  | Departure Airline:
Departure Flight No: |  |  |  |  |  |  |  |  |  | Return Flight No:
Employee Signature: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date:
*Approving Authority
Team Leader/Supervisor: |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Approve |  |  |  |  |  | Disapprove
 |  |  |  |  |  | Print Name
Signature: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date:
*Approving Authority
Deputy Program Manager: |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Approve |  |  |  |  |  | Disapprove
 |  |  |  |  |  | Print Name
Signature: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date:
*Approving Authority
Program Manager: |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Approve |  |  |  |  |  | Disapprove
 |  |  |  |  |  | Print Name
Signature: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date:
Travel Arrangements Required  (ensure your request includes the following…)
Copy of Pay Voucher: |  |  |  |  | T/S Calendar: |  |  |  |  |  | PTO Calculator: |  |  |  |  |  |  | ALL Itineraries submitted (within 30 days of approval):
Justification for submissions required if request is within 90 days of last PTO, PTO longer than 30 days in duration, PTO submission less than 30 days from start of PTO or requested LWOP.  Ensure reason for exception is clear and concise, but fully explains the circumstances behind the deviation from standard request guidelines.
Reason:
 |  | This form is to be completely filled in. Incomplete forms will not be accepted by the Admin Office.
FOR OFFICE USE ONLY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | ADMIN OFFICE Comments
Admin Signature:
Date:
Commando Program PTO Form  For Program Management Use Only