LSJ, LLC
6100 Red Hook Quarters Suite 8-3 St. Thomas, VI 00802-1348 Tel: ax: 340-775-8108
E-mail:
Vacation / Leave Form
Name:
T-A.OO74s. rY-1 air.) itc. is
Date of Request 3/19 //
Dates ofRequested:
Date of First Day of Vacation: Date Return to Work
Total Number of Days:
Leave Days: imp) Weekend Days: a Holidays: Personal / Sick: DaysRemainfirl
Type ofLeave:
r<acation with Pay r Leave without pay C' Personal Sick Leave C' Other
If Other Explain:
List ofallcontact information:
Phone:
Cell:
Email:
The following must be verified with Estate Manager
1. The number of vacation days you have taken.
2. The number employee In your division /department that are leave at the same time
Approved:
EFTA01130132