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Weekly Administrative Leave Report
(Agencies are required to submit a weekly update once an employee has been in an administrative leave status for over 80 consecutive hours)
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Extensions Beyond 240 Hours
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Submit DateAgency CodeEmployee NameEINEmployme nt StatusAdm. Leave Start
Date		Hours on Adm.
Leave		Anticipate d End DateReason for Leave (Description)# of Hours Requeste
d		Addition al Hours Approve
d		StatusActual Adm. Leave End
Date
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ASPS/HRD - FA6.01
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