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LEAVE TIME RE UEST <br />� ;_ . J <br />Name � 't , . Date ' � ` _ <br />Type of Leave : � <br />�Vacation . . . . . .number of hours of vacation <br />Comp. Time .....number of hours of comp. tim� <br />�Sick . . . . . . . .tim� City was �all�d <br />Person taking call <br />Medical �, ...... time of appc�intment, f rom to <br />Conference/train�n�.locatian �' <br />Topic <br />Leave af absence with p���r <br />Rcason <br />'✓�L�aWe of absenc� without pay <br />Rcason <br />Other (Sp�ci�y1 <br />Dat�(s) of abs�nce: From =� T� <br />�omments: <br />Departm�nt/Division <br />sup�rUisor <br />Depar�m�nt �iead <br />City Manager � <br />