diff --git a/src/pages/08_request-list/FormCancel.vue b/src/pages/08_request-list/FormCancel.vue
new file mode 100644
index 00000000..4490418d
--- /dev/null
+++ b/src/pages/08_request-list/FormCancel.vue
@@ -0,0 +1,21 @@
+<script lang="ts" setup>
+const reason = defineModel<string>('reason');
+</script>
+<template>
+  <article>
+    <q-input
+      dense
+      outlined
+      type="textarea"
+      v-model="reason"
+      hide-bottom-space
+      class="full-height"
+      :label="
+        $t('general.remark', { msg: $t('requestList.status.RejectCancel') })
+      "
+      :rules="[(val) => !!val || $t('form.error.required')]"
+    />
+  </article>
+</template>
+
+<style scoped></style>