Vacation / Absence Request Form

Name Name * First Last
Email *
Position *
Purpose of request *

Purpose of request Annual Vacation Absence Request
Annual vacation
Absence request
Purpose *

Purpose Personal Leave Time Off for Marriage Paternal Leave Educational Leave Family day, according to 138 chapter of the Lithuanian Labor Law Birthday Leave Other
From From * / MM / DD YYYY
Until Until * / MM / DD YYYY
Number of working days *
Add another date
Date #2
From From * / MM / DD YYYY
Until Until * / MM / DD YYYY
Number of working days *
Add another date
Date #3
From From * / MM / DD YYYY
Until Until * / MM / DD YYYY
Number of working days *
To be paid *

To be paid Yes No
Please pay my vacation pay *

Please pay my vacation pay with upcoming salary one day before vacation start
Supervisor's information
Name of your supervisor Name of your supervisor * First Last
Email of your Supervisor
(make sure it’s correct) *
*

I certify all information is true and correct to the best of my knowledge
Name (acts as your digital signature) Name (acts as your digital signature) * First Last
Date Date / MM / DD YYYY