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PTO Request Form
(Time Off Request)
Employee Name
Employee ID
Department
Supervisor
Job Title
Date of Request
Type of Leave
Leave Type
Dates Requested
Date
Day
Start Time
End Time
Hours
Notes
Total
PTO Balance
Available
Requested
Balance After
Return Date
Coverage & Comments
Employee Signature
Date
Supervisor Approval
Decision
Comments / Reason
Supervisor Signature
Date
※ Submit requests as early as possible. Sick leave and family/medical leave rights (including FMLA and state paid-leave laws) may apply regardless of this form.
How to fill out a PTO Request Form
Free PTO Request Form template
A PTO (paid time off) request form lets an employee ask for vacation, sick, personal or other leave in writing. It records the dates and hours requested, the remaining balance and who will cover the work, and gives the supervisor a place to approve or deny it.
How to fill it out
Fill in your name, ID, department, supervisor and job title.
Check the type of leave.
List each day off with start and end times and hours — the total adds up automatically.
Enter your available balance and balance after leave, and your return date.
Describe coverage, sign, and give the form to your supervisor for approval.
Tips
Submit vacation requests as early as your policy requires.
Enter hours as decimals (e.g. 4.5).
Sick leave and FMLA or state paid leave may be protected even if not approved in advance.
Keep a copy of the approved form for your records.
PTO Request Form example
Employee Name
Jane Smith
Employee ID
E-1015
Department
Customer Service
Supervisor
Michael Brown
Job Title
Customer Service Supervisor
Type of Leave
Leave Type
Vacation
Dates Requested
11/23/2026 · Monday · 8:30 AM · 5:00 PM · 8
11/24/2026 · Tuesday · 8:30 AM · 5:00 PM · 8
11/25/2026 · Wednesday · 8:30 AM · 12:30 PM · 4 · Half day
PTO Balance
Available
62 hours
Requested
20 hours
Balance After
42 hours
Return Date
11/27/2026
Coverage & Comments
Lisa Chen will cover the escalation queue. Open tickets will be handed off on Friday, November 20.
Supervisor Approval
Decision
Approved
Comments / Reason
Approved — enjoy the holiday.
All names, companies and contact details are fictional. Click “Fill sample” above to put this example into the empty fields; click again to remove the parts you did not change.
FAQ
How far in advance should I request PTO?
Follow your company policy; two weeks is common for vacation. Unplanned sick leave is usually reported as soon as possible.
Can I export it to Excel?
Yes. Download → Excel file (.xlsx) keeps your entries and the hours total as a live formula.
Can an employer deny a PTO request?
Often yes for vacation, based on business needs, but some leave (like protected sick or family leave) may not be denied. Rules vary by state.
