Crime-Victim and Witness Court-Attendance Leave Request Packet
SUBPOENAED WITNESS AND EMPLOYER-NOTIFICATION REQUEST PACKET
Florida — Fla. Stat. §§ 92.57 and 960.001(1)(i)
1. EMPLOYEE AND EMPLOYER
| Field | Entry |
|---|---|
| Employee | [________________________________] |
| Employer | [________________________________] |
| Position / department | [________________________________] |
| HR / supervisor contact | [________________________________] |
| Preferred confidential contact | [________________________________] |
2. SUBPOENA-PROTECTION GATE
- ☐ Employee will testify in a judicial proceeding.
- ☐ The testimony is in response to a subpoena.
Section 92.57 is not limited to a crime victim, but it requires subpoenaed testimony. It does not cover jury service or a voluntary appearance without a subpoena.
3. PROCEEDING AND ABSENCE
Court / tribunal: [________________________________]
Case identifier, using the minimum information needed: [________________________________]
Subpoenaed date and time: [________________________________]
Expected work absence: [DATE / START / END]
Operational notice date, method, and recipient: [________________________________]
Employee signature: __________________________ Date: ______________
4. VICTIM OR WITNESS NOTIFICATION ASSISTANCE
If the employee is a victim or witness cooperating in a prosecution, § 960.001(1)(i) provides assistance, upon request, from law enforcement and the state attorney in informing the employer that cooperation may require absence from work.
- ☐ Employee requests employer-notification assistance.
- ☐ Assistance is not requested.
Law-enforcement or state-attorney contact: [________________________________]
Requested scheduling confirmation: [________________________________]
5. MINIMUM SUPPORTING RECORD
- ☐ Subpoena
- ☐ Court scheduling notice
- ☐ State-attorney or law-enforcement confirmation
- ☐ Other minimally necessary record: [________________________________]
Do not attach police reports, medical records, victim addresses, or offense narratives when the subpoena or scheduling confirmation is sufficient.
6. PAY AND EMPLOYMENT TREATMENT
The cited sections do not state a paid-leave entitlement.
- ☐ Unpaid time
- ☐ Accrued paid leave: [TYPE / HOURS]
- ☐ Schedule adjustment: [________________________________]
- ☐ Other treatment: [________________________________]
7. EMPLOYER RESPONSE
- ☐ Subpoenaed-testimony route confirmed
- ☐ Absence recorded: [________________________________]
- ☐ Notification assistance received / pending
- ☐ Pay treatment recorded
- ☐ Counsel review required
An employee may not be dismissed because of the nature of subpoenaed testimony or employment absences resulting from compliance with the subpoena. A civil action may include actual damages, and the court may award attorney fees and punitive damages.
Employer representative: _____________________ Date: ______________
8. CHANGE LOG
| Date | Court update | Employee / agency notice | Revised schedule |
|---|---|---|---|
| [________] | [________________] | [________________] | [________________] |
| [________] | [________________] | [________________] | [________________] |
OFFICIAL SOURCES VERIFIED
About This Template
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on 2026-08-11.
Legal authority: Fla. Stat. § 92.57 (protection from dismissal for subpoenaed testimony and resulting employment absence; civil remedies); Fla. Stat. § 960.001(1)(i) (law-enforcement and state-attorney employer-notification assistance for a requesting victim or witness)
Last updated: 2026-08-11
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