📄 Extracted Text (171 words)
LSJE, LLC
6100 Red Hook larters, 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: 102/21/19 Date of Return to Work 03/11/19
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: 14
Number of vacation days granted per this request:
Leave without Pay:
Number of vacation days remaining after this request:
Personal/Sick Days:
■
Holidays: 1
Number of medical days permitted annually
Weekend Days: 6
Number of medical days used year-to-date:
Other.**
Number of medical days granted per this request:
Total Days Away: 121 1
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.
EFTA01223547
ℹ️ Document Details
SHA-256
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Bates Number
EFTA01223547
Dataset
DataSet-9
Document Type
document
Pages
1
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