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How do I apply for VESSA leave?

Employees in need of VESSA leave should use the Victims' Economic Security & Safety Act (VESSA) Leave Request Form found on the HR Forms website (

The employee must provide advance notice of at least 48 hours for the need to take leave unless it is not practical to provide such notice.

The employee must provide certification and corroborating evidence of the need for leave to the Benefits Department.