Time Off Submission Employee Time-Off Request Keep All Requests in the same week. If less than two week notice you must talk to management. Please call the office and if somebody does not answer, leave a voicemail and explanation. (859) 303-4040. Please submit each day for the hours you are scheduled for. Name(Required) First Last Email(Required) Leave Type(Required) Do Not Use PTO Sick PTO Vacation PTO Reason / Notes (Optional)Sunday HoursPlease enter a number from 1.0 to 8.0.Sunday Date(Required) Monday HoursPlease enter a number from 1.0 to 8.0.Monday Date(Required) Tuesday HoursPlease enter a number from 1.0 to 8.0.Tuesday Date(Required) Wednesday HoursPlease enter a number from 1.0 to 8.Wednesday Date(Required) Thursday HoursPlease enter a number from 1.0 to 8.0.Thursday Date(Required) Friday HoursPlease enter a number from 1.0 to 8.0.Friday Date(Required) Saturday HoursPlease enter a number from 1.0 to 8.0.Saturday Date(Required) Total Hours RequestedConsent(Required) I agree to the Independence Assistance’s “Paid Time Off” policies.
