Free time-off request form.
A time-off request form records who wants to be away, the dates, the coverage plan and the manager’s decision. Use this template to keep a request separate from an approval.
What should a time-off request include?
Include the employee’s name, first and last day away, return date and proposed covering teammate, with space for the manager’s decision. Ample’s free form can be printed or copied into a document. Completing the form does not submit a request to Ample or approve the leave.
One-page PDF · Editable text version · No signup or email required
Print it. Fill it. Confirm it.
The PDF is a blank form to print and complete by hand. For an editable version, copy the text below into Word or Google Docs.
From dates to a decision
- Record the dates and return day.
- Name the people covering the work.
- Leave the decision to the reviewer.
Copyable PTO request template
TIME-OFF REQUEST Employee: Team: Submitted on: Leave type: First day away: Last day away: Expected return date: Partial days or working hours affected (if applicable): COVERAGE AND HANDOFF Work that needs attention: Agreed covering owner(s): Handoff document link: Work that can wait until I return: MANAGER DECISION — complete after review Status: Pending / Approved / Declined / Discuss dates Reviewed by: Decision date: Confirmed dates: Coverage actions to resolve: Submitting a request does not mean it has been approved. Confirm the decision and update the team's shared schedule. This template is for planned time off. Follow your organization's separate process for unexpected absences or leave requiring confidential documentation. Keep medical details out of a shared coverage document. Free template from Ample — https://www.ampletime.ai/time-off-request-form/
Copy into your own document or print a blank form. This page does not collect completed requests.
What should a PTO request include?
- Dates: the first and last day away, the expected return date, and any partial days.
- Coverage: the work that needs attention and the people who have agreed to cover it.
- A decision: requested and approved leave should have different statuses, with a named reviewer and decision date.
- A handoff: link to the instructions the covering teammate will actually use.
Example: a request with a clear next step
Alex requests Monday through Thursday off and plans to return Friday. Sam agrees to handle customer escalations; the weekly internal report can wait. The manager checks overlapping leave, records the decision and confirms the dates. Alex then links the vacation handoff from the shared schedule.
How to use the form
- Fill in the dates and coverage notes, following your team’s request process.
- Send it to the person responsible for reviewing leave.
- Have the reviewer check the team schedule and record a decision.
- After approval, update the shared schedule and confirm the handoff with each covering owner.
Does this work for unlimited PTO?
Yes. An unlimited PTO team still needs dates, a decision and coverage. This form has no accrued-balance calculation. Teams with an allowance should check their balance in their existing system.
Is a submitted form an approval?
No. Keep the request marked pending until your reviewer confirms the decision. If dates change, ask the reviewer to confirm the revised dates and update the shared schedule.
Bring requests and coverage together
Need a shared record? Our free PTO tracking spreadsheet keeps dates, status and named cover in one file.
Ample gives unlimited-PTO teams a shared leave schedule, request review and handoff notes. Join the waitlist for early access; see current pricing for larger teams.
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