Crime-Victim and Witness Court-Attendance Leave Request Packet - Louisiana
VICTIM OR WITNESS EMPLOYER-NOTIFICATION ASSISTANCE PACKET
Louisiana — La. R.S. 46:1848 and 46:1844(E)
Important: This is an employer-notification assistance request, not a mandatory-leave or pay demand.
1. REQUESTING PERSON AND EMPLOYER
| Field | Entry |
|---|---|
| Requesting employee | [________________________________] |
| Employer | [________________________________] |
| Position / department | [________________________________] |
| HR / supervisor contact | [________________________________] |
| Preferred confidential contact | [________________________________] |
2. ELIGIBILITY AND CASE GATE
Select the applicable route:
- ☐ Crime victim under La. R.S. 46:1842
- ☐ Designated family member under La. R.S. 46:1842
- ☐ Witness
- ☐ Victim or witness in an alleged-delinquent-act case under La. Ch.C. art. 811.1
Status confirmed by judicial agency, law-enforcement agency, prosecutor, victim-witness program, or counsel: [________________________________]
The adult-case route concerns cooperation in the prosecution of a criminal case. Confirm the controlling route before sending this packet.
3. APPEARANCE OR COOPERATION INFORMATION
Court or agency: [________________________________]
Case identifier, using the minimum necessary information: [________________________________]
Appearance or cooperation date and time: [________________________________]
Expected work absence: [DATE / START / END]
- ☐ Subpoena securely presented, if issued
- ☐ Scheduling notice securely presented
- ☐ Prosecutor or agency confirmation securely presented
- ☐ Cancellation or continuance updates requested
Do not attach police reports, medical records, victim addresses, or offense narratives unless current law or counsel requires them.
4. REQUEST FOR EMPLOYER-NOTIFICATION ASSISTANCE
I request assistance from the appropriate judicial or law-enforcement agency in informing my employer that my participation in the prosecution may necessitate absence from work.
Requested limited contact:
- ☐ Confirm the required or requested participation.
- ☐ Confirm the date and expected duration.
- ☐ Request a schedule adjustment.
- ☐ Request consideration of available paid leave.
- ☐ Request consideration of unpaid time.
- ☐ Provide an update if the appearance is canceled or continued.
- ☐ Other limited coordination: [________________________________]
The cited provisions establish assistance with employer notification; they do not themselves require the employer to grant leave or pay.
Employee authorizes this limited employer contact by: [________________________________]
Employee signature: __________________________ Date: ______________
5. ASSISTANCE RECORD
| Field | Entry |
|---|---|
| Assisting agency / office | [________________________________] |
| Assisting representative | [________________________________] |
| Employer contact | [________________________________] |
| Contact date and method | [________________________________] |
| Minimum information disclosed | [________________________________] |
| Employer response | [________________________________] |
| Follow-up needed | [________________________________] |
Assisting representative: ____________________ Date: ______________
6. EMPLOYER COORDINATION RESPONSE
- ☐ Absence approved under policy, agreement, or another law
- ☐ Schedule adjusted
- ☐ Paid leave available: [TYPE / HOURS]
- ☐ Unpaid time available: [HOURS]
- ☐ Benefit treatment: [________________________________]
- ☐ Additional minimally necessary confirmation requested
- ☐ Counsel review required
Employer representative: _____________________ Date: ______________
Response delivered to employee and assisting representative: [DATE / METHOD]
7. CHANGE LOG
| Date | Case update | Assistance update | Work adjustment |
|---|---|---|---|
| [________] | [________________] | [________________] | [________________] |
| [________] | [________________] | [________________] | [________________] |
OFFICIAL SOURCES VERIFIED
About this template
- Last updated
- August 11, 2026
- Citations checked
- August 11, 2026
- Jurisdiction
- Louisiana
- Category
- Employment & HR
Legal authority
- La. R.S. 46:1848(C)(9) and (D)(3) (Crime Victims' Bill of Rights employer-notification assistance)
- La. R.S. 46:1844(E) (judicial and law-enforcement employer-notification assistance)
- La. Ch.C. art. 811.1(A)(12) (employer-notification assistance in an alleged-delinquent-act case)
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.
Not legal advice
This template is provided for informational purposes. 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 August 11, 2026.
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