Crime-Victim and Witness Court-Attendance Leave Request Packet

CRIME-VICTIM OR REPRESENTATIVE PARTICIPATION REQUEST PACKET

Arkansas — Ark. Code § 16-90-1105

1. EMPLOYEE AND EMPLOYER

2. COVERED-PERSON GATE

• ☐ Employee is the victim.
• ☐ Employee is a representative of the victim.

Representative capacity, using the minimum information needed: [________________________________]

Coverage confirmed by prosecutor, victim advocate, or counsel: [NAME / OFFICE / DATE]

3. SELECT ONE PROTECTED ROUTE

• ☐ Employee will participate, at the prosecuting attorney's request, in preparation for a criminal-justice proceeding.
• ☐ Employee will attend a criminal-justice proceeding because attendance is reasonably necessary to protect the victim's interests.

This section does not create a general witness, jury-duty, civil-case, or unrelated voluntary-attendance route.

4. ABSENCE REQUEST

Court / prosecutor's office: [________________________________]

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

Date and time: [________________________________]

Expected work absence: [DATE / START / END]

Operational notice date, method, and recipient: [________________________________]

Employee signature: __________________________ Date: ______________

5. MINIMUM SUPPORTING RECORD

• ☐ Prosecuting-attorney preparation request
• ☐ Prosecutor or court confirmation that attendance is reasonably necessary
• ☐ Court scheduling notice
• ☐ Other minimally necessary confirmation: [________________________________]

Do not attach charging papers, police reports, medical records, victim addresses, or detailed offense narratives unless current law or counsel requires them.

6. PAY AND SCHEDULING

Section 16-90-1105 prohibits discharge or discipline but does not specify paid leave, a leave-bank rule, or a fixed notice deadline.

• ☐ Unpaid time
• ☐ Accrued paid leave under policy or agreement: [TYPE / HOURS]
• ☐ Schedule adjustment: [________________________________]
• ☐ Other treatment: [________________________________]

7. EMPLOYER RESPONSE

• ☐ Victim or representative status confirmed
• ☐ Protected preparation or attendance route confirmed
• ☐ Absence recorded: [________________________________]
• ☐ Pay treatment recorded
• ☐ Counsel review required

An employer may not discharge or discipline a covered victim or representative for the selected protected activity.

Employer representative: _____________________ Date: ______________

Decision delivered to employee: [DATE / METHOD]

8. CHANGE LOG

OFFICIAL SOURCES VERIFIED

• Arkansas Legislature — Act 1262 of 1997, § 6
• Arkansas Department of Public Safety — current victim-rights information