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

CRIME-VICTIM COURT-ATTENDANCE LEAVE REQUEST PACKET

Virginia — Va. Code § 40.1-28.7:2

Use this packet only for an employee who qualifies as a victim under Va. Code § 19.2-11.01(B) and seeks to attend a covered criminal proceeding relating to the crime against that employee. Do not use this route merely because an employee is an ordinary witness, has a civil hearing, or received a jury summons.

1. EMPLOYEE AND EMPLOYER

2. VICTIM-STATUS GATE

Check the applicable Va. Code § 19.2-11.01(B) route after review with the prosecutor, victim-witness program, or counsel:

• ☐ Employee suffered physical, psychological, or economic harm directly from a felony, an offense specifically listed in § 19.2-11.01(B), or a covered delinquent act.
• ☐ Employee is a spouse or child included in the statutory victim definition.
• ☐ Employee is the parent or legal guardian of a minor victim.
• ☐ Employee is a qualifying spouse, parent, sibling, or legal guardian of a victim who is incapacitated or was a homicide victim.
• ☐ Other statutory victim route confirmed by: [NAME / OFFICE / DATE].
• ☐ The exclusion for a family member who committed the offense does not apply.

Do not attach charging papers, police reports, medical records, a victim address, or narrative evidence to this packet unless current law or counsel specifically requires it.

3. CRIMINAL-PROCEEDING GATE

The employee requests leave for this proceeding:

• ☐ Initial appearance of the suspected offender
• ☐ Post-arrest release or release-condition proceeding
• ☐ Presentation of a negotiated plea
• ☐ Sentencing
• ☐ Postconviction release-from-confinement proceeding
• ☐ Probation revocation disposition or requested probation termination
• ☐ Requested probation modification substantially affecting victim contact, safety, restitution, or incarceration status

Court / tribunal: [________________________________]

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

Proceeding date and scheduled time: [________________________________]

Expected work absence: [DATE / START / END]

4. REQUIRED DOCUMENT DELIVERY

Va. Code § 40.1-28.7:2(B) conditions this leave route on delivery of the applicable documents.

• ☐ Copy of the standardized victim-rights form supplied by law enforcement under Va. Code § 19.2-11.01(A)
• ☐ Copy of the notice of this scheduled criminal proceeding, if applicable

Delivery date: [________________________________]

Secure delivery method and recipient: [________________________________]

The employee requests that the employer restrict these records to personnel who need them to administer the absence. This privacy request does not alter any disclosure required by law.

5. EMPLOYEE REQUEST

I request leave from [START] through [END] on [DATE] to attend the criminal proceeding identified above.

If the requested period creates a significant operational difficulty, please contact me promptly to discuss a lawful limitation or scheduling adjustment that still permits attendance to the extent practicable.

Pay selection:

• ☐ Unpaid time under this statutory route
• ☐ Apply available accrued paid leave if permitted by policy or another law: [TYPE / HOURS]
• ☐ Other pay treatment reviewed by HR or counsel: [________________________________]

Va. Code § 40.1-28.7:2 does not require compensation for the covered absence.

Employee signature: __________________________ Date: ______________

6. EMPLOYER REVIEW

• ☐ Victim route confirmed
• ☐ Covered criminal proceeding confirmed
• ☐ Standardized law-enforcement form received
• ☐ Proceeding notice received, if applicable
• ☐ Leave approved as requested
• ☐ Leave limited because the requested absence creates an undue hardship as defined by § 40.1-28.7:2
• ☐ Counsel review required

If leave is limited, identify the significant difficulty and expense, including the size of the business and the critical need for the employee, without requesting unnecessary victim information:

[____________________________________________________________]

Alternative or limited schedule offered: [________________________________]

Final approved absence: [________________________________]

Pay / leave-bank treatment: [________________________________]

Va. Code § 40.1-28.7:2 prohibits dismissal and other listed employment discrimination because an individual uses covered leave to attend a criminal proceeding.

Employer representative: _____________________ Date: ______________

Decision delivered to employee: [DATE / METHOD]

7. CHANGE OR CANCELLATION LOG

OFFICIAL SOURCES VERIFIED

• Virginia Law — Va. Code § 40.1-28.7:2
• Virginia Law — Va. Code § 19.2-11.01