REQUEST AND AUTHORITY FOR LEAVE OF ABSENCE (Commissioned Officers) - PDF Document
DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE COMMISSIONED CORPS. REQUEST AND AUTHORITY FOR LEAVE OF ABSENCE (Commissioned Officers). TO BE COMPLETED BY THE OFFICER (Type or Print). NAME. GRADE. SSN. PHS NO. PERIOD OF ABSENCE. REMARKS. Through (mm/dd/yyyy). NO. DAYS.
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