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

CRIMINAL-WITNESS PAID-ABSENCE AND EMPLOYER-INTERCESSION PACKET

West Virginia — W. Va. Code §§ 18A-5-3a and 61-11A-6(a)(8)

Use Part A only for the narrow Board of Education employee route. Use Part B for victim-or-witness employer-notification assistance. Part B is an intercession request, not a mandatory-leave demand.

1. EMPLOYEE AND EMPLOYER

2. COURT APPEARANCE

Court: [________________________________]

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

Appearance date and time: [________________________________]

Expected work absence: [DATE / START / END]

• ☐ Subpoena securely presented
• ☐ Scheduling notice securely presented
• ☐ Cancellation or continuance updates requested

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

PART A — BOARD OF EDUCATION EMPLOYEE PAID-ABSENCE ROUTE

3A. STATUTORY GATE

Confirm every box before using Part A:

• ☐ The employee is employed by a West Virginia Board of Education.
• ☐ The employee was subpoenaed to appear as a witness.
• ☐ The employee is not a defendant in the proceeding.
• ☐ The proceeding is criminal.
• ☐ The appearance is in a court of law.

If any box is not confirmed, do not represent section 18A-5-3a as the source of paid absence.

4A. PAID-ABSENCE REQUEST

The employee requests treatment of the subpoenaed appearance under W. Va. Code section 18A-5-3a without loss of pay.

Travel allowances are excluded from the witness-fee offset used in the statutory calculation.

Employee signature: __________________________ Date: ______________

5A. BOARD RESPONSE

• ☐ Statutory gate confirmed
• ☐ Absence recorded without loss of pay
• ☐ Witness-fee amount confirmed
• ☐ Board-paid difference confirmed
• ☐ Payroll correction required: [________________________________]
• ☐ Counsel review required

Board representative: ________________________ Date: ______________

PART B — VICTIM OR WITNESS EMPLOYER-NOTIFICATION ASSISTANCE

3B. INTERCESSION GATE

• ☐ The employee is a victim.
• ☐ The employee is a witness.
• ☐ Cooperation in the prosecution may necessitate absence from work.
• ☐ The employee requests assistance from a law-enforcement agency or prosecuting attorney in informing the employer.

Confirmation by law enforcement, prosecutor, or victim-witness program: [________________________________]

4B. LIMITED INTERCESSION REQUEST

The employee requests employer-notification assistance under W. Va. Code section 61-11A-6(a)(8) and W. Va. C.S.R. section 142-4-4.10.

• ☐ Explain the prosecution-cooperation need to the employer.
• ☐ Confirm the appearance date and expected duration.
• ☐ Request a schedule adjustment.
• ☐ Request consideration of available paid leave.
• ☐ Request consideration of unpaid time.
• ☐ Provide an update if the appearance is canceled or continued.
• ☐ Other limited coordination: [________________________________]

The cited intercession provisions do not themselves require the employer to grant leave or pay.

Employee authorizes this limited employer contact by: [________________________________]

Employee signature: __________________________ Date: ______________

5B. INTERCESSION 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: ______________

6. CHANGE LOG

OFFICIAL SOURCES VERIFIED

• West Virginia Legislature — W. Va. Code § 18A-5-3a
• West Virginia Legislature — W. Va. Code § 61-11A-6
• West Virginia Secretary of State — 142 C.S.R. 4 active rule record