Election-Worker Service Leave Request and Appointing-Authority Certification Packet

ELECTION-OFFICER TRAINING OR SERVICE LEAVE REQUEST

Kentucky — KRS 118.035(4)

1. EMPLOYEE AND EMPLOYER

2. SELECTION AND PURPOSE

Selecting authority: [________________________________]

Election: [TYPE / DATE]

Election-officer role: [________________________________]

Purpose:

• ☐ Attend required election-officer training
• ☐ Serve as an election officer

Training or service date: [________________________________]

3. EMPLOYEE REQUEST

KRS 118.035(4) permits a selected election officer to be absent for an entire day to attend training or serve. The employer may specify the hours during which the employee may be absent.

Requested absence: [DATE / START / END]

Employee signature: __________________________ Date: ______________

4. SELECTING-AUTHORITY CERTIFICATION

I certify that [EMPLOYEE] was selected to serve as an election officer and is required for the training or service identified above.

Required hours: [________________________________]

Compensation, if any: [________________________________]

Authorized signature: _________________________ Date: ______________

Printed name / title / contact: [________________________________]

5. EMPLOYER HOURS AND PAY

Employer-specified absence hours: [________________________________]

Section 118.035(4) prohibits refusal, discharge, threatened discharge, or another penalty because the employee exercises the privilege. It does not itself state that the absence must be paid.

• ☐ Unpaid time
• ☐ Accrued paid leave voluntarily selected: [________________________________]
• ☐ Paid civic or administrative leave under another authority: [________________________________]
• ☐ Other: [________________________________]

6. EMPLOYER RESPONSE

• ☐ Selection confirmed
• ☐ Training route approved
• ☐ Election-service route approved
• ☐ Absence hours specified
• ☐ No penalty imposed
• ☐ Counsel / labor-relations review required

Employer representative: _____________________ Date: ______________

Decision delivered: [DATE / METHOD]

OFFICIAL SOURCE VERIFIED

• Kentucky Legislature — KRS 118.035