📄 Extracted Text (174 words)
LSJE, LLC
6100 Red Hook Carters, Suite B-3, St. Thomas, VI 00802-1348
Phone- E-mail:
Vacation/Leave Form
Gerry Anthony Titre
Name: Cell:
Division/Department:
I
Maintenance/RO Phone (other):
Date Request Submitted: 01/09/19 E-mail:
Dates of Vacation/Leave Requested:
Date of Vacation/Leave to Begin:
K l /25/19 Date of Return to Work 02/04/19
Number of employees in your division/department expected to be absent during your requested vacation/leave?* 0
For internal use only:
Total Number of Days Away: Number of vacation days permitted annually:
Number of vacation days used year-to-date:
Vacation with Pay: FM
Number of vacation days granted per this request:
Leave without Pay: 0
Number of vacation days remaining after this request:
Personal/Sick Days: 0
Holidays: 0
Number of medical days permitted annually
Weekend Days:
Number of medical days used year-to-date:
Other:** 0
Number of medical days granted per this request:
Total Days Away: 110 I
Number of medical days remaining after this request:
"If "Other: please explain:
Employee Signature: Date:
Authorization: Approval Date:
'Areas indicatedmust be verified with the supervisor before vacation/leave wilt be approved.
EFTA01223546
ℹ️ Document Details
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Bates Number
EFTA01223546
Dataset
DataSet-9
Document Type
document
Pages
1
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