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Leave Request (NOT Requiring ERSC Authorization)

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About this Form

Form number: 430-1A

Audience:  MCPS Staff

Last revised: June 2011

Related Forms

Form 430-1A2 - Leave Request (NOT Requiring ERSC Authorization)

Form 430-1 - Leave Request (Requiring ERSC Authorization)

Form 430-94 - Professional Leave (PRO)

INSTRUCTION: To be completed when an employee is requesting annual or personal leave for any number of days/hours, bereavement leave for 5 days or fewer, or all other types of leave for 4 days or fewer. Leave requests not meeting these criteria should be submitted on MCPS Form 430-1. Attach copies of appropriate documentation and submit to your principal/director/supervisor. Approved form must be attached to employee’s timesheet. Refer to reverse side for detailed instructions.
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