LEAVE APPLICATION FORM

Employee Name Designation

Employee No Department

Type Of Leave

Annual Leave Unpaid Leave

Sick Leave (attachment) Maternity Leave
Emergency Leave Others

Period of leave (day)s :

Date of Leave (date) : From To

I will resume duty on (date) :

Reason for Application :

Applicant's duties relieved by :-

Employee Name : :
Employee No : :

Signature : :

Recommended by:-

Employee Signature Head of Department

Date : Date :

*Note : It is condition of leave that is subject to be resciended at any time by the management if is desirable in the interest of the company with the employee if is desirable in the interest of the company
with the employee to continue to perform for which he/she has been granted leave

Total Leave Entitlement Approved

Total Balance Leave Deffered
Total Balance Leave After Application Rejected

Received by:- Approved / Deffered / Rejected by :-

Human Resource Department Chief Operation Executive

Date : Date :
Remarks : Remarks :