Type of Leave: Wed 17th Feb 2016 Weekend Days: 2 Holidays: (*I Vacation with Pay C' Leave without pay If Other Explain: Date Return to Work: Personal / Sick : r Personal Sick Leave C Other Tues Feb 23rd 2016 Days Remaing. 52 days Days Remaining Based on Vacation to be taken in March/April List of a

Leave Days: 2 i Weekend Days: Type of Leave: 2 Holidays: C Vacation with Pay C Leave without pay If Other Explain: 3 Date Return to Work: Personal / Sick: r Personal Sick Leave Other December 19th, 2011 Days Remaing: 58 days Holidays - Labor Day, Thanksgiving Day, Thanksgiving Friday List of all

eave: Friday September 18th 2015 Weekend Days: 4 Holidays: R Vacation with Pay C' Leave without pay If Other Explain: 1 Date Return to Work: Personal / Sick: r Personal Sick Leave C Other Tuesday September 29th 2061 Days Remoing: 40 days Holiday - Labor Day List of all contact information: Phone:

v Days: Type 2 I Leave: May 5th 2011 Weekend Days: 2 Holidays: V cation with Pay r Leave without pay If Oth Explain: Date Return to Work: Personal / Sick : r Personal Sick Leave C' Other May 9th 2011 Days Remaing: 11 days List o all contact information: Phon Cell: Email: The fo owing must be

Leave: Thursday 17th Sept 2015 Weekend Days: 4 Holidays: FIT Vacation with Pay C Leave without pay If Other Explain: 1 Date Return to Work: Personal / Sick : r Personal Sick Leave r Other Monday 27th Sept 2015 Days Remaing: 40 days Holiday - Labor Day List of all contact information: Phone: Cell