PTO Reimbursement Form

A PTO reimbursement request form is used by employees to claim compensation for unused vacation or paid time off. The form documents the number of hours being reimbursed and ensures compliance with company policies.

Employees who have accrued but unused PTO and qualify for a payout—such as those resigning, retiring or in organizations with a PTO cash-out policy—must complete this form.

This form is submitted to HR, payroll or management for approval. Some companies may require additional documentation or signatures before processing the request.