Crime-Victim and Witness Court-Attendance Leave Request Packet

CRIME-VICTIM, FAMILY-MEMBER, OR WITNESS COURT-ATTENDANCE LEAVE REQUEST PACKET

California — Cal. Gov. Code § 12945.8

Select one statutory route. Do not combine them merely to obtain broader coverage.

1. EMPLOYEE AND EMPLOYER

2. SELECT ONE ROUTE

Route A — subpoenaed or court-ordered witness

• ☐ The employee will appear in court to comply with a subpoena or other court order.
• ☐ The employee will appear as a witness in a judicial proceeding.

Route A is not limited to a crime victim. Section 12945.8(c)'s reasonable-advance-notice condition does not list subdivision (a)(2), but the employee should provide operational notice when practicable without surrendering the statutory protection.

Route B — victim or family member attending a crime-related judicial proceeding

• ☐ The employee is a qualifying victim under § 12945.8(j)(8)(C); or
• ☐ The employee is the family member of a qualifying victim.
• ☐ The proceeding is related to that crime.

Covered examples include a delinquency proceeding, postarrest release decision, plea, sentencing, postconviction release decision, or proceeding where a right of the victim or family member is at issue.

Family-member route selected: ☐ child ☐ parent ☐ grandparent ☐ grandchild ☐ sibling ☐ spouse ☐ domestic partner ☐ designated person

If “designated person” is selected, record only that the blood relationship or association is the equivalent of a family relationship. An employer may limit the employee to one designated person per 12-month period for this section.

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

3. PROCEEDING AND ABSENCE

Court / tribunal: [________________________________]

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

Proceeding type: [________________________________]

Date and time: [________________________________]

Expected work absence: [DATE / START / END]

4. NOTICE

For Route B, the employee must give reasonable advance notice unless advance notice is not feasible.

• ☐ Route A operational notice given: [DATE / METHOD / RECIPIENT]
• ☐ Route B reasonable advance notice given: [DATE / METHOD / RECIPIENT]
• ☐ Route B advance notice was not feasible. Brief timing explanation: [________________]

Employee signature: __________________________ Date: ______________

5. MINIMUM CERTIFICATION

For an unscheduled Route B absence, an employer may request certification within a reasonable time after the absence. Use only the minimum sufficient record:

• ☐ Court or prosecuting-attorney evidence of appearance
• ☐ Written statement signed by the employee or a person acting for the employee certifying an authorized purpose
• ☐ Other certification category allowed by § 12945.8(c)(2): [________________________________]
• ☐ Route A subpoena or court order

Do not attach police or medical records, victim addresses, or offense narratives when a court record or signed certification is sufficient. Required confidentiality applies to information related to Route B leave to the extent stated in § 12945.8(c)(3).

6. PAY AND LEAVE COORDINATION

An employee may use otherwise available vacation, personal leave, paid sick leave, or compensatory time, subject to the terms of employment and any collective-bargaining agreement. Review concurrency and unpaid-leave limits under § 12945.8(h)-(i).

• ☐ Unpaid time
• ☐ Available paid leave: [TYPE / HOURS]
• ☐ Concurrent protected leave review: [________________________________]
• ☐ Schedule adjustment: [________________________________]

7. EMPLOYER RESPONSE

• ☐ Route A confirmed
• ☐ Route B victim/family and crime-related proceeding gates confirmed
• ☐ Notice timing recorded
• ☐ Minimum certification received or not requested
• ☐ Absence approved / recorded: [________________________________]
• ☐ Counsel review required

Section 12945.8 prohibits discharge, discrimination, or retaliation for covered time off and makes interference with or denial of its rights an unlawful employment practice.

Employer representative: _____________________ Date: ______________

Confidential storage location / access role: [________________________________]

8. CHANGE LOG

OFFICIAL SOURCE VERIFIED

• California Legislative Information — Cal. Gov. Code § 12945.8