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Paid Time Off Request (CPTO) - Cancel / Reschedule

Instructions: Use this form to cancel scheduled/approved Paid Time Off (PTO) and request approval to reschedule.

Employee Name

Project Number

Employee e-mail address

Day One

Date Requested +

# of hrs1

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

Day Two

Date Requested +

# of hrs2

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

Day Tree

Date Requested +

# of hrs3

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

Day Four

Date Requested +

# of hrs4

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

Day Five

Date Requested +

# of hrs5

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

Day Six

Date Requested +

# of hrs6

Reschedule?

Yes

No

Reschedule Date +

# of hrs1

- - -

Total Hours Requested

0.00

Total Hours Rescheduled

0.00

Total Hours Cancelled

0.00

If your request was for more than 6 days of PTO, please complete and submit a second cancellation / rescheduling request.

Notes/Comments

-

Send form to supervisor:

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2020.12.08 Revision 1.1