Form 9611: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field, ensuring you include your first name, last name, and middle initial.
Next, input your Social Security Number in the appropriate section for identification purposes.
Fill in your position details, including title, series, and grade to provide context for your leave request.
Select the purpose of your leave by checking the relevant box that corresponds to your situation—be it for birth, adoption, care of a family member, or personal health issues.
Indicate both the anticipated starting and ending dates of your leave to clarify the duration.
Specify the total number of hours needed for each type of leave: sick leave, annual leave, and leave without pay.
If applicable, indicate whether medical certification is included with your application by selecting 'Yes' or 'No.'
Provide any additional information relevant to your application in the space provided.

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