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

EMPLOYER-INTERCESSION AND QUALIFIED STATE-EMPLOYEE SAFE-LEAVE PACKET

Utah — Utah Code §§ 77-37-2, 77-37-3, and 63A-17-511.5

Use Part A for victim or prosecution-witness employer intercession. Use Part B only for paid safe leave available to a qualified employee of a covered Utah state employer. Part A is not a mandatory-leave or pay demand.

1. EMPLOYEE AND EMPLOYER

2. COURT OR CRIMINAL-JUSTICE ACTIVITY

Court, prosecutor, agency, or victim-witness program: [________________________________]

Case or matter identifier, using the minimum necessary information: [________________________________]

Activity and its connection to the criminal-justice process: [________________________________]

Activity date and time: [________________________________]

Expected work absence: [DATE / START / END]

• ☐ Subpoena or scheduling notice securely presented, if issued
• ☐ Timely cancellation or continuance updates requested
• ☐ Only minimum information necessary for workplace coordination will be disclosed

Do not attach police reports, medical records, victim addresses, offense narratives, or other sensitive material unless current law or counsel requires them.

PART A — VICTIM OR PROSECUTION-WITNESS EMPLOYER INTERCESSION

3A. STATUTORY GATE

Select one:

• ☐ Victim route. The employee is an individual, including a minor, against whom an offense has allegedly been committed.
• ☐ Prosecution-witness route. The employee has been subpoenaed, is expected to be summoned to testify for the prosecution, or has relevant information and is subject or likely to be called as a prosecution witness.

Confirmation by an officer of the court, responsible agency, prosecutor, counsel, or victim-witness program: [________________________________]

Section 77-37-3 provides reasonable employer-intercession services, including pursuing employer cooperation to minimize loss of pay and other benefits resulting from participation in the criminal-justice process. Officers of the court provide those services and should consider victim and witness schedules to avoid conflicts. If a victim's conflicts cannot be avoided, the victim may ask the responsible agency to intercede with an employer or another party.

4A. LIMITED INTERCESSION REQUEST

I request employer-intercession services under Utah Code section 77-37-3(1)(g):

• ☐ Explain the criminal-justice participation need to the employer
• ☐ Confirm the activity date and expected duration
• ☐ Seek a schedule adjustment to avoid a conflict
• ☐ Request consideration of available paid leave
• ☐ Request consideration of unpaid time
• ☐ Seek cooperation to minimize loss of pay or other benefits
• ☐ Provide an update if the activity is canceled or continued
• ☐ Other limited coordination: [________________________________]

The cited intercession provision does not itself require the employer to grant leave, preserve pay or benefits, or accept a requested schedule.

Employee authorizes this limited employer contact by: [________________________________]

Employee signature: __________________________ Date: ______________

5A. INTERCESSION RECORD AND EMPLOYER RESPONSE

• ☐ Absence approved under policy, agreement, or another law
• ☐ Schedule adjusted
• ☐ Paid leave available: [TYPE / HOURS]
• ☐ Unpaid time available: [HOURS]
• ☐ Additional minimally necessary confirmation requested
• ☐ Counsel review required

Employer representative: _____________________ Date: ______________

Intercession provider: ________________________ Date: ______________

PART B — QUALIFIED STATE-EMPLOYEE PAID SAFE LEAVE

3B. COVERED STATE-EMPLOYER GATE

Select the employer category:

• ☐ State executive-branch agency, including the State Tax Commission, National Guard, or Board of Pardons and Parole
• ☐ Utah legislative branch
• ☐ Utah judicial branch

Section 63A-17-511.5 excludes the following from its definition of state employer. Confirm that none applies:

• ☐ Institution of higher education
• ☐ Utah Board of Higher Education
• ☐ State Board of Education
• ☐ Independent entity under Utah Code section 63E-1-102
• ☐ Attorney General's office
• ☐ State Auditor's office

• ☐ State Treasurer's office

• ☐ No listed exclusion applies.

• ☐ Coverage is uncertain; counsel review required.

4B. QUALIFIED-EMPLOYEE AND VICTIM GATE

Confirm every employee-qualification item:

• ☐ Position receives retirement benefits under Title 49.
• ☐ Employee accrues paid leave benefits usable in the current and future calendar years.
• ☐ Employee is not a reemployed retiree as defined in Utah Code section 49-11-1202.

Select the victim route:

• ☐ Employee is a victim of domestic violence, sexual assault, stalking, or human trafficking.
• ☐ Employee's immediate family member is a victim of that conduct.

For this route, immediate family means the employee's parent, spouse, child, or sibling, or an individual claimed as a dependent for state or federal income-tax purposes. A child is an individual younger than 18.

5B. COURT-HEARING SAFE-LEAVE PURPOSE

• ☐ The requested safe leave is related to or arises from the qualifying incident.
• ☐ The employee needs the leave to attend or participate in a court hearing.
• ☐ Another listed safe-leave purpose also applies: [________________________________]

Safe-leave dates and hours requested: [________________________________]

Section 63A-17-511.5 permits up to one week of paid safe leave per calendar year. The amount is prorated under applicable division rules for a part-time employee or an employee working more than the equivalent of a 40-hour workweek.

6B. LEAVE BALANCE, TIMING, AND NOTICE

Before safe leave is granted, the employee must exhaust available accrued annual, compensatory, and excess leave balances.

• ☐ Safe leave will be used within two years after the qualifying incident.
• ☐ More than two years have passed, but the use relates to criminal prosecution of the alleged perpetrator.
• ☐ Leave will be used intermittently.
• ☐ Any applicable Family and Medical Leave Act leave will run concurrently.

Safe leave does not accrue annually and does not increase because more than one qualifying incident occurred.

The employee generally must give notice at least seven days before beginning safe leave and at least seven days before stopping safe leave.

• ☐ Start notice provided at least seven days in advance.
• ☐ Stop notice provided at least seven days in advance.
• ☐ Circumstances beyond the employee's control prevented seven-day notice; notice was given as soon as reasonably practicable.

Notice details: [________________________________]

7B. EMPLOYEE REQUEST AND STATE-EMPLOYER RESPONSE

I request paid safe leave under Utah Code section 63A-17-511.5 for the court-hearing purpose recorded above.

Employee signature: __________________________ Date: ______________

• ☐ Covered state-employer gate confirmed
• ☐ Qualified-employee gate confirmed
• ☐ Victim or immediate-family gate confirmed
• ☐ Court-hearing purpose confirmed
• ☐ Required leave balances exhausted
• ☐ Timing and notice route confirmed
• ☐ Paid safe leave approved: [DATES / HOURS]
• ☐ Safe leave not charged against sick, annual, compensatory, excess, or other leave, except for applicable FMLA concurrency
• ☐ Return to the same position or an equivalent position in seniority, status, benefits, and pay confirmed
• ☐ Employment-related benefits and payments continued at the same level, subject to required employee contributions
• ☐ No interference, restraint, or retaliatory action
• ☐ Counsel review required

Unused safe leave is not payable at termination. A reduction in force may apply as section 63A-17-511.5(8)(b) provides.

State-employer representative: _______________ Date: ______________

Decision delivered to employee: [DATE / METHOD]

8. CHANGE LOG

OFFICIAL SOURCES VERIFIED

• Utah Legislature — Utah Code § 77-37-2
• Utah Legislature — Utah Code § 77-37-3
• Utah Legislature — Utah Code § 63A-17-511.5
• Utah Legislature — 2024 S.B. 174 official bill page