Employee Bereavement Leave Extension Request

Employee Bereavement Leave Extension Request — Form Fields

This hr template includes 11 fields. Request an extension to standard bereavement leave when additional time is needed beyond the company policy default. Free to customize and use on ZenBuild.

• Employee Full Name (text, required)
• Employee Email (email, required)
• Department (text, required)
• Manager Name (text, required)
• Name of Deceased (text, required)
• Relationship to Deceased (dropdown selection, required) — options: Spouse/partner, Parent, Child, Sibling, Grandparent, In-law, Other
• Date Leave Began (text, required)
• Standard Bereavement Days Used (number, required)
• Additional Days Requested (number, required)
• Reason for Extension Request (long text, required)
• Will you use PTO for the additional days? (multiple choice, required) — options: Yes, No – requesting unpaid leave, Unsure