HR Time Off Request Cancellation Form
Submit this form to request cancellation of a previously approved time off. Please provide accurate details for HR review.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Work Email Address
*
example@example.com
Original Time Off Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Original Time Off End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Time Off
*
Please Select
Paid Time Off (PTO)
Unpaid Leave
Sick Leave
Personal Leave
Other
Reason for Cancellation
*
Please acknowledge that cancelling a time off request may impact your leave balance and department planning.
*
I acknowledge and accept the consequences of this cancellation.
Additional Comments (optional)
Submit Cancellation Request
Should be Empty: