Request PTO (paid time off)

How to request PTO pay:

If this is scheduled time off (for the future), request it in Homebase.
Complete the form below at least 21 days before the requested payday (for scheduled time off) or as soon as you can (for illness or other unscheduled time off).
Your supervisor will indicate whether your request has been approved, and PTO pay will be received in your regular paycheck for that pay period.

Name

First Name

Last Name

Email Address

Date(s) of PTO requested

From:

MM

DD

YYYY

To:

MM

DD

YYYY

Number of hours requested (each day = 8 hours)

How many total hours are you requesting for PTO pay?

What kind of leave do you need?

Continuous leave (I will need to be out all of the days, in a row, continuously.)

Intermittent leave (I will need to be out here and there; on specific days/times or varying days/times.)

It was an unscheduled request (illness, etc.); it's not really "leave."

If you need intermittent leave, could you tell us more about it?

If known, what days, hours, etc. do you think you'll need?

Number of hours available

According to your last paystub, how many PTO hours do you have available? Write "don't know" if you don't know.

Have you requested the time off in Homebase?

Yes

No

Has your supervisor granted your time off request?

Yes

No

I haven't requested the time off yet.

I've requested the time, but my supervisor hasn't responded yet.