Time Off Request Form - W643A - ct 2026

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  1. Click ‘Get Form’ to open the Time Off Request Form - W643A - ct in the editor.
  2. Begin by filling in your name and date at the top of the form. This ensures that your request is properly attributed.
  3. Specify the dates you are requesting time off. Use the provided fields to indicate whether this is for vacation, personal leave, or sick leave by selecting the appropriate time reporting code.
  4. Indicate the total hours you will be away and specify the times of day you will not be at work.
  5. If applicable, provide details for any other type of leave in the designated section.
  6. Sign the form to confirm your request and submit it for approval. Your supervisor will then review and sign it as well.
  7. Remember to attach a copy of this form with your biweekly time sheet if approved.

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