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Get TX 40-2L 2008-2024

Signature of Applicant or Individual Applying on Behalf of Applicant PS Form 3970-R August 1999 Page 1 of 2 Date Signed Section II - Approval Completed by applicant s supervisor I certify that 1 the applicant has documented a serious personal health condition and the need for extended absence because of such condition 2 the applicant has been 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 accum.

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