@jeraldz,
Dear Boss:
As we have discussed in the past, I am having issues with my family. My mother is ill (or whatever the reason -- you're going to need some specifics here but don't get into TMI. That is, you can say, if it applies, that she has breast cancer, but not go into the specifics of her treatment) and I will need to go home and care for her. Therefore I am formally asking for a leave of absence, starting on November 10th.
I am hoping to be back at work on November 18th. If there is a delay of any sort, I will let you know.
If there is any way I can do any work remotely during that time, please let me know as I do not want to neglect my duties and still wish to help the company as much as I can.
My family and I are all hoping for my mother to have a full and speedy recovery, and we all greatly appreciate your support during this difficult time.
Sincerely,
(your name)
(the snail mail address where you'll be)
(the phone number where you'll be)
(an email address you can access while you're away)