NAVPERSCOM 12630/1. CIVILIAN REQUEST FOR EXTENDED LEAVE - public navy 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Part I, which requires your personal information such as Employee Name, PD Title, Series/Grade, and PERS Code. Ensure accuracy as this information is crucial for processing your request.
3. Next, indicate the type of leave requested by checking the appropriate boxes and entering the number of hours for each type. Remember to attach any necessary medical documentation if applicable.
4. In the Family and Medical Leave section, provide the period covered by your leave request. Specify dates and ensure that you check all relevant boxes regarding family or personal health conditions.
5. Complete the certification statement at the bottom of Part I by signing and dating it. This confirms that all provided information is accurate and that you understand your responsibilities.
6. For Parts II and III, ensure that your supervisors complete their sections by providing their signatures and dates. This step is essential for approval.

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