Volunteer Emergency-Responder Work-Absence Notice and Verification Packet - Idaho
IDAHO RED CROSS DISASTER-SERVICE LEAVE PACKET
State employees — Idaho Code § 67-5338
1. ELIGIBILITY WORKSHEET
| Field | Entry |
|---|---|
| Employee | [________________________________] |
| State agency | [________________________________] |
| Supervisor / HR | [________________________________] |
| Red Cross unit | [________________________________] |
- ☐ Employee works for the State of Idaho.
- ☐ Employee is a certified American Red Cross disaster-service volunteer.
- ☐ Disaster is Red Cross level III or higher.
- ☐ Governor or President declared the disaster.
- ☐ Service will occur in Idaho or a state contiguous to Idaho.
- ☐ Written Red Cross request is attached.
Prior § 67-5338 leave in the relevant twelve-month period: [________] hours.
Requested leave: [________] hours.
- ☐ Aggregate will not exceed 120 work hours.
- ☐ Part-time proportional entitlement has been calculated.
2. EMPLOYEE REQUEST
I request paid leave from [START] through [END] to provide American Red Cross disaster-relief services.
Disaster / declaration: [________________________________]
Service location and duties: [________________________________]
Employee signature: __________________________ Date: ______________
3. RED CROSS WRITTEN REQUEST
The American Red Cross requests the disaster-relief services of [EMPLOYEE], a certified disaster-service volunteer.
| Item | Verification |
|---|---|
| Disaster level | [________________________________] |
| Declaration authority | [________________________________] |
| Service location | [________________________________] |
| Expected service period | [________________________________] |
Red Cross official: __________________________ Date: ______________
Official contact: [________________________________]
4. AGENCY RECORD
- ☐ State-employment status confirmed
- ☐ Certification and written Red Cross request confirmed
- ☐ Level III-or-higher declaration confirmed
- ☐ Idaho / contiguous-state location confirmed
- ☐ 120-hour or part-time proportional balance confirmed
- ☐ Approved as paid leave in addition to other paid leave or vacation
Approved hours: [________]
Agency representative: ________________________ Date: ______________
5. COMPLETION AND DELIVERY LOG
Actual service period and duties: [________________________________]
| Date | Item | Method | Receipt |
|---|---|---|---|
| [________] | [________________] | [________] | [________________] |
| [________] | [________________] | [________] | [________________] |
OFFICIAL SOURCE VERIFIED
About this template
- Last updated
- August 10, 2026
- Citations checked
- August 10, 2026
- Jurisdiction
- Idaho
- Category
- Employment & HR
Legal authority
- Idaho Code § 67-5338 (paid Red Cross disaster-service leave for State of Idaho employees)
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 10, 2026.
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