Crime-Victim and Witness Court-Attendance Leave Request Packet

CRIME-VICTIM COURT-ATTENDANCE LEAVE REQUEST PACKET

Rhode Island — R.I. Gen. Laws § 12-28-13

1. EMPLOYEE AND EMPLOYER

2. COVERAGE GATE

• ☐ Employer has 50 or more employees.
• ☐ Employee is a victim of a crime.
• ☐ Employee will attend court proceedings related to that crime.

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

This route does not cover an ordinary witness who is not the victim, jury service, or a court matter unrelated to the crime against the employee.

3. COURT PROCEEDING AND ABSENCE

Court: [________________________________]

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

Proceeding date and time: [________________________________]

Expected work absence: [DATE / START / END]

Travel or waiting time requested: [________________________________]

4. REQUIRED NOTIFICATION DOCUMENT

Before leaving work, the employee must provide the employer a copy of the court-proceeding notification provided under R.I. Gen. Laws § 12-28-3.

• ☐ Required notification copy attached
• ☐ Delivered securely on: [DATE / METHOD / RECIPIENT]

Do not add police reports, medical records, victim addresses, or detailed offense narratives unless current law or counsel requires them.

Employee signature: __________________________ Date: ______________

5. PAY, LEAVE BANKS, AND SENIORITY

The employer need not compensate the employee for this leave. The employee may elect to use, or the employer may require use of, accrued paid vacation, personal leave, or sick leave. The employee must not lose seniority or precedence during covered absence.

• ☐ Unpaid time
• ☐ Employee elects accrued leave: [TYPE / HOURS]
• ☐ Employer requires accrued leave: [TYPE / HOURS]
• ☐ Seniority / precedence preservation recorded

6. UNDUE-HARDSHIP REVIEW

The employer may limit leave if it creates an undue hardship to the business.

• ☐ No undue hardship identified
• ☐ Counsel review required before limiting leave

Business hardship and proposed lawful limitation, without unnecessary victim information:

[____________________________________________________________]

Alternative schedule or limited leave: [________________________________]

7. EMPLOYER RESPONSE

• ☐ Employer-size threshold confirmed
• ☐ Crime-victim and related-court gates confirmed
• ☐ Required notification received
• ☐ Leave approved as requested: [________________________________]
• ☐ Leave limited after undue-hardship review: [________________________________]
• ☐ Pay and seniority treatment recorded

The employer may not dismiss a covered employee because the employee exercises this leave right.

Employer representative: _____________________ Date: ______________

Decision delivered to employee: [DATE / METHOD]

8. CHANGE LOG

OFFICIAL SOURCE VERIFIED

• Rhode Island Legislature — R.I. Gen. Laws § 12-28-13