Vacation / Absence Request Form
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
Sporadic Leave
Maternity Leave
Other
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