Crime-Victim and Witness Court-Attendance Leave Request Packet - New Hampshire
CRIME-VICTIM EMPLOYMENT LEAVE REQUEST PACKET
New Hampshire — RSA 275:62–:63
Use this packet only for an employee who is a victim of a crime and seeks to attend a court or other legal or investigative proceeding associated with prosecution of that crime.
1. EMPLOYEE AND EMPLOYER
| Field | Entry |
|---|---|
| Employee | [________________________________] |
| Employer | [________________________________] |
| Position / department | [________________________________] |
| HR / supervisor contact | [________________________________] |
| Preferred confidential contact | [________________________________] |
2. ELIGIBILITY AND PROCEEDING GATE
- ☐ Employee's crime-victim status was confirmed by the court, prosecutor, law-enforcement agency, victim-witness program, or counsel.
- ☐ Court proceeding
- ☐ Other legal proceeding associated with prosecution
- ☐ Investigative proceeding associated with prosecution
Court or agency: [________________________________]
Case identifier, using the minimum necessary information: [________________________________]
Proceeding date and time: [________________________________]
Expected work absence: [DATE / START / END]
3. REQUIRED NOTICE DOCUMENT
Before leaving work under RSA 275:62, the employee must provide the employer a copy of the notice of each scheduled hearing, conference, or meeting furnished by the court or responsible agency.
- ☐ Required scheduling notice attached or securely presented
Delivery date, method, and recipient: [________________________________]
The employer must maintain the confidentiality of written documents or records submitted concerning this request.
4. EMPLOYEE REQUEST
I request leave from [START] through [END] on [DATE] for the prosecution-related proceeding identified above.
RSA 275:62 does not require compensation. Leave-bank selection:
- ☐ Employee elects accrued vacation, personal, or sick leave: [TYPE / HOURS]
- ☐ Employer requires use of accrued vacation, personal, or sick leave: [TYPE / HOURS]
- ☐ Unpaid time
- ☐ Other treatment under policy or another law: [________________________________]
Employee signature: __________________________ Date: ______________
5. EMPLOYER REVIEW
- ☐ Employee crime-victim route confirmed
- ☐ Prosecution-related proceeding confirmed
- ☐ Required scheduling notice received
- ☐ Leave approved as requested
- ☐ Leave limited under RSA 275:63 because it creates undue hardship
- ☐ Pay / leave-bank treatment: [________________________________]
- ☐ Confidential storage location: [________________________________]
For RSA 275:63, undue hardship means significant difficulty and expense and includes business size, the employee's position and role, and the employer's need for the employee.
RSA 275:62 prohibits discharge because the employee exercises this leave right and preserves seniority during the absence.
Employer representative: _____________________ Date: ______________
Decision delivered to employee: [DATE / METHOD]
6. CHANGE LOG
| Date | Proceeding update | Employee notice | Work adjustment |
|---|---|---|---|
| [________] | [________________] | [________________] | [________________] |
| [________] | [________________] | [________________] | [________________] |
OFFICIAL SOURCES VERIFIED
About this template
- Last updated
- August 11, 2026
- Citations checked
- August 11, 2026
- Jurisdiction
- New Hampshire
- Category
- Employment & HR
Legal authority
- N.H. Rev. Stat. § 275:62 (crime-victim leave, documents, pay, seniority, confidentiality, and discharge protection)
- N.H. Rev. Stat. § 275:63 (undue-hardship limitation)
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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