Ad 1046-2026

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  1. Click ‘Get Form’ to open the ad 1046 in the editor.
  2. Begin by completing Part I of the form, which includes your personal information such as name, position title, and social security number.
  3. In section 14, indicate the anticipated duration of your medical emergency by filling in the beginning and ending dates.
  4. Attach a brief statement describing your medical emergency along with a medical certificate that outlines your condition and expected recovery time.
  5. Once completed, submit the application to your immediate supervisor for their concurrence before sending it to the designated agency office.

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