PTO request form
A PTO request form turns "can I take Friday off?" into a dated record of what was asked, what was approved and how many hours came off the balance. This template covers the dates and hours, the type of leave, coverage while the employee is out, and the manager's decision. Read it below, then share it as a link your team fills in whenever they need time off.
Updated November 5, 2026 · 4 min read
The contract
Gray blanks are yours to fill in before you send. Each signer fills in the blanks in their color.
- You, before sending
- Employee
- Manager
Paid Time Off (PTO) Request Form
Company: Company name. Employee: Employee name. Department or crew: Department or crew. Employee ID: Employee ID.
1. Time requested
First day off: First day off. Last day off: Last day off. I will be back at work on Return to work date.
Total hours requested: Total hours requested. Partial days, with the date and the hours I will be away: Partial days.
2. Type of leave
Tick every type that applies. If the request mixes types, list the hours for each in the partial days blank above.
- Vacation
- Personal day
- Planned sick leave or a medical appointment
- Bereavement
- Jury duty or a court appearance as a witness
- Unpaid leave
- Other: Other leave type
This time off is for my own serious health condition, a family member's, the birth, adoption or foster placement of a child, or a family member's military service. I understand HR will contact me about leave the law may protect, separately from this request.
3. Balance
Hours available to me before this request, from my latest pay statement or the HR system: Hours available. If my balance does not cover the request, I understand the extra hours will be unpaid unless my manager agrees otherwise in section 6.
4. Coverage and handover
While I am away, my work will be covered by Covering coworker. Handover notes, open jobs or customers to watch: Handover notes.
5. Company policy
Requests should be made at least Notice days days before the first day off, except for emergencies and sick leave the law protects. Approval depends on staffing and is not guaranteed. When two requests conflict, the earlier request is considered first unless the written policy says otherwise. The full PTO policy is at PTO policy location. This form does not change that policy or any right I have under the law.
6. Manager's decision
- Approved as requested.
- Approved with these changes: Changes to the request
- Not approved, because: Reason not approved
Hours to deduct from the employee's balance: Hours to deduct. If the employee ticked the protected-leave box, I have passed this request to HR.
7. After a decision
The manager will try to decide within Days to decide working days of receiving this request. Once time off is approved, the Company will not cancel it except for a genuine business emergency, and if it does, it will reimburse reasonable non-refundable costs the employee has already paid, such as a deposit on travel, when the employee shows a receipt. To cancel or change approved time off, the employee sends a new request as early as possible; hours not taken go back into the balance.
Company holidays that fall inside the approved dates are paid as holidays and are not deducted from the balance. PTO is paid at the employee's regular rate on the normal payday for the period in which it is taken. If the employee cannot return on the date in section 1, they will tell the manager before their next scheduled shift.
8. Records
The signed form is kept with the Company's payroll and attendance records, and the employee receives a copy. Information about health or family reasons for leave is kept separately and shared only with the people who need it to handle the leave.
I confirm the dates and hours above are correct and that I have arranged coverage where my job needs it.
Employee
Manager
Opens it in SignMaster as a template you can edit and send.
A starting point, not legal advice. Have a lawyer review it for your state and situation.
On this page
Why put time off in writing
Most time-off arguments come down to memory: who approved the week in July, whether the half day was ever taken, how two people from the same crew ended up out at once. A signed request settles those questions and tells payroll how many hours to deduct. It protects employees too, who get a copy of the approval instead of relying on a yes in the hallway.
Use one form for vacation, personal days and planned medical appointments. A sudden illness can't wait for a form, and sick leave laws in many states and cities limit how much notice or paperwork you can demand, so record those absences after the fact.
What the template covers
- Who and when: the employee, their department, the first and last day off, and the day they're back.
- Hours: the total requested, with partial days spelled out, so payroll deducts the right amount.
- Type of leave: vacation, personal, sick, bereavement, jury duty or unpaid, as tick boxes.
- Balance: the hours available before the request, from the latest pay stub or the HR system.
- Coverage: who handles the work while the employee is out, plus handover notes.
- A protected-leave flag: a box the employee ticks if the time off is for a serious health condition or family reason, so HR follows up.
- The decision: approved as asked, approved with changes or not approved, with a reason, the hours to deduct and the manager's signature.
Mistakes managers make with PTO
- Approving by text and never writing it down. Payroll needs the hours, and you need the record when two people want the same week.
- Saying no without a reason. A short note such as "two of four techs already out" shows the decision was about coverage, not the person.
- Treating a medical or family absence as ordinary PTO. If the leave may qualify under the FMLA or a state leave law, you have separate notice duties, whatever you decide about the PTO.
- Letting balances go negative by accident. Ask for the available hours on the form and check them before you sign.
- Applying the policy unevenly. A standard form makes it easier to treat the same request the same way every time.
How to set it up in SignMaster
- 1
Open the template
Choose Use this template above. It comes with two signers: the employee, who fills in the request, and the manager, who decides.
- 2
Add your policy details
Fill in the gray blanks your whole team shares: the company name, how many days' notice you ask for, and where employees can read the full PTO policy.
- 3
Share it as a public link
Turn the template into a public signing link. The employee is the person who opens it; assign the manager role to a named approver.
- 4
Request, then decide
The employee picks dates, hours and the type of leave and signs. The approver gets an email, ticks a decision, adds a reason if needed and signs.
- 5
Both keep a copy
When the approver signs, both get the signed PDF with its certificate of completion, a record payroll can work from.
Every request in one table
Each submitted form becomes its own envelope, so a busy summer can mean dozens of them. The template's Responses tab lists every answer in one table, with names, dates, hours, leave type and the decision, and exports it as CSV or JSON for payroll or a shared calendar. Responses is on every paid plan; see all answers to a template in one table.
Questions? Answers.
Can a manager approve PTO electronically?
Yes. The box the manager ticks and their signature are recorded, with the date and time, in the signed PDF and its certificate of completion. That's a better record than an email reply.
How much notice should employees give for time off?
Whatever your written policy says, as long as it's reasonable and applied the same way to everyone. Type your number into the notice blank, and remember that protected sick leave may need less.
Do we have to pay out unused PTO when someone leaves?
It depends on your state and your written policy. Some states treat earned vacation as wages that must be paid at separation and forbid use-it-or-lose-it rules; others let the policy decide. Check with your state's labor department.
What if the time off might be FMLA leave?
Decide the PTO request as usual, but tell HR straight away. Under federal rules, once you know leave may be for an FMLA reason, you generally have five business days to give the employee an eligibility notice.