Employee Time Off to Vote Notice Acknowledgement Form
Notify your employer of your need for time off to vote and acknowledge receipt of this notice.
Employee Full Name
*
First Name
Last Name
Department
*
Employee Email Address
*
example@example.com
Date Requested for Time Off to Vote
*
-
Month
-
Day
Year
Date
Time Range Requested for Voting (e.g., 9:00 AM - 11:00 AM)
*
Reason for Time Off
*
In-person voting
Absentee ballot drop-off
Other
Employee Acknowledgment: I acknowledge receipt of this notice and confirm my request for time off to vote.
*
I acknowledge
Manager Review / Comments
Manager Name
Submit
Should be Empty: