Crime-Victim and Witness Court-Attendance Leave Request Packet - Alaska

CRIME-VICTIM TESTIMONY OR INVESTIGATION-COOPERATION REQUEST PACKET

Alaska — Alaska Stat. § 12.61.017

Use this packet only when the employee is the victim of the offense and is requested to testify or cooperates with law enforcement concerning that offense. It is not a general witness-subpoena, jury-duty, family-member, or civil-proceeding form.

1. EMPLOYEE AND EMPLOYER

2. COVERAGE GATE

The employee confirms:

• ☐ I am the victim of the offense involved.
• ☐ The request concerns that offense, not an unrelated matter.
• ☐ The applicable activity is selected below.

Covered activity:

• ☐ I was subpoenaed to attend a court proceeding to give testimony.
• ☐ The prosecuting attorney requested that I attend a court proceeding to give testimony.
• ☐ I reported the offense to a law-enforcement agency.
• ☐ I am participating in a law-enforcement investigation of the offense.

Confirming prosecutor or law-enforcement contact: [NAME / OFFICE / DATE]

3. ABSENCE REQUEST

Court, agency, or meeting location: [________________________________]

Case or incident identifier, using the minimum information needed: [________________________________]

Date and scheduled time: [________________________________]

Expected work absence: [DATE / START / END]

Travel or waiting time requested: [________________________________]

Employee signature: __________________________ Date: ______________

4. MINIMUM SUPPORTING RECORD

• ☐ Subpoena
• ☐ Prosecutor request confirming testimony attendance
• ☐ Law-enforcement request confirming investigation participation
• ☐ Other minimally necessary confirmation: [________________________________]

Do not attach police reports, medical records, a victim address, photographs, or an offense narrative unless current law or counsel specifically requires them.

Secure delivery date, method, and recipient: [________________________________]

5. PAY AND BENEFITS

Section 12.61.017 permits loss of pay and benefits directly attributable to the protected absence. Determine any paid treatment under employer policy, an agreement, or another law.

• ☐ Unpaid time
• ☐ Accrued paid leave: [TYPE / HOURS]
• ☐ Schedule adjustment: [________________________________]
• ☐ Other treatment reviewed by HR or counsel: [________________________________]

6. EMPLOYER RESPONSE

• ☐ Victim status confirmed with minimum disclosure
• ☐ Covered testimony or law-enforcement route confirmed
• ☐ Absence recorded for: [________________________________]
• ☐ Pay and benefits treatment recorded
• ☐ Counsel review required

An employer may not penalize or threaten to penalize a covered victim. The statute's protected employment interests include status, wages, and benefits, subject to the direct-absence pay exception above.

Employer representative: _____________________ Date: ______________

Decision delivered to employee: [DATE / METHOD]

7. COMPLIANCE AND CHANGE LOG

Section 12.61.017 makes a violation an offense and permits a victim who suffers pecuniary loss to seek actual damages plus punitive damages equal to three times actual damages. Refer any dispute promptly to counsel.

OFFICIAL SOURCE VERIFIED

• Alaska Legislature — Alaska Stat. § 12.61.017