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Get PS 3970-R 1999-2024

and/or will be granted approved absence due to this health problem; (3) the health condition is not job related; and (4) the employee has or is expected to accumulate 40 or more hours of leave without pay due to this condition in addition to the depletion of his or her earned annual and sick leave balances. Approved Disapproved (Give reason) Signature and Title of Supervisor Date Signed Date the applicant accumulated (or will accumulate) 40 hours of LWOP due to this personal health conditio.

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