LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802-1348 Tel: 340-775-8100 Fax: 340-775-8108 E-mail: Vacation / Leave Form Name: Date of Request: 'ir /18 Dates of Requested: Date of First Day of Vacation: Total Number of Days: Leave Days: 5 Type of Leave: Saturday 20th October 2018 Weekend Days: Holidays: r: Vacation with Pay Leave without pay Date Return to Work: Personal / Sick : C Personal Sick Leave C Other Monday 29th October 2018 Days Remain g: 98 days If Other Explain: 'Approved Verbally JE 9/28118 List of all contact information: Phone: Cell: Email: The following must be verified with Estate Manager 1. The number of vacation days you have taken. 2. The number employee in your division / department that are leave at the same time Approved: EFTA00305832