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

CRIMINAL-PROCEEDING EMPLOYMENT-PROTECTION REQUEST PACKET

Missouri — Mo. Rev. Stat. § 595.209.1(14)

1. EMPLOYEE AND EMPLOYER

2. COVERED-PERSON AND RIGHTS GATE

• ☐ Employee is a witness.
• ☐ Employee is a victim.
• ☐ Employee is a member of a victim's immediate family.

Rights status:

• ☐ Rights apply automatically because the victim is within an automatically covered offense class under § 595.209.1.
• ☐ A written request for rights was made because the employee's route is within the request-based class.

Written-request date and recipient, if applicable: [________________________________]

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

3. SELECT PROTECTED ACTIVITY

• ☐ Honoring a subpoena to testify in a criminal proceeding
• ☐ Attending a criminal proceeding
• ☐ Participating in preparation of a criminal proceeding

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: ______________

4. MINIMUM SUPPORTING RECORD

• ☐ Subpoena
• ☐ Court scheduling notice
• ☐ Prosecutor confirmation of attendance or preparation
• ☐ Written request for victim/witness rights, if applicable
• ☐ Other minimally necessary record: [________________________________]

Do not attach charging papers, police reports, medical records, victim addresses, or offense narratives when the selected confirmation is sufficient.

5. PAY AND LEAVE BANKS

The employer may not require the covered employee to use vacation, personal time, or sick leave for the protected activity. Section 595.209.1(14) does not expressly require compensation.

• ☐ Unpaid time without forced leave-bank use
• ☐ Employee voluntarily elects accrued leave: [TYPE / HOURS]
• ☐ Other pay treatment under policy or agreement: [________________________________]

6. EMPLOYER RESPONSE

• ☐ Covered person and automatic/request-based route confirmed
• ☐ Protected criminal activity confirmed
• ☐ Absence recorded: [________________________________]
• ☐ No vacation, personal, or sick leave required
• ☐ Pay treatment recorded
• ☐ Counsel review required

An employer may not discharge or discipline a covered witness, victim, or immediate-family member for the protected activity.

Employer representative: _____________________ Date: ______________

7. CHANGE LOG

OFFICIAL SOURCE VERIFIED

• Missouri Revisor of Statutes — Mo. Rev. Stat. § 595.209