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.

Download printable PDF Download editable Word Download .txt

Printable PDF · Editable Word and text versions · No signup or email required

Print it. Fill it. Confirm it.

Use the PDF for handwriting, the Word document to type your request, or the plain-text version in your team’s own document. Every format keeps the request and reviewer decision separate.

From dates to a decision

Record the dates and return day.
Name the people covering the work.
Leave the decision to the reviewer.

Choose the format you need

Word document (.docx): Type into the bracketed prompts, adjust the space for longer answers and save a new copy for each request. The document is editable text, not a form that submits online.
Printable PDF: Print the blank form and write in the fields. Use the Word version when you want to type or change the layout.
Plain text: Copy the template into an email, Google Doc or another editor. Add your team’s own headings or instructions as needed.

Complete the editable Word request

Download the .docx file and open it in Word. Save a copy so you keep a blank version for next time.
Replace each bracketed prompt. Include both the last day away and the return date; for a partial day, state the hours affected.
Agree on covering owners and link the handoff instructions. Use the coverage planner to check overlapping absences.
Keep the reviewer section marked pending and send the saved copy through your team’s usual request process. The download does not notify a manager.

Keep completed requests in your organization’s approved storage. The downloadable document has no macros or automatic submission. Do not include medical details in a shared coverage plan.

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.

Get early access

Check PTO coverage →Prepare a handoff →Explore unlimited PTO tracking →

Sending an email with your request? Use our time-off request email templates, and count the working days in your vacation before submitting.