O.P.

JINDAL SUPER THERMAL POWER PLANT

JINDAL POWER LTD TAMNAR, RAIGARH
TITLE:

LEAVE APPLICATION FORM

Doc. No. Issue No. / Date Rev. No / Date

PNA/F/01 01/01-09-2008 00/01-09-2008

Date

Name of the Applicant E. Code Department Designation Leave From ( date & day) Leave to (date & day) :

: : : : :

Kind of Leave (CL/EL/ML/Other) : Purpose of leave Contact address while on leave : :

Tel No. while on leave Person In charge in your

: :

absence (Name and designation)

APPLICANTS SIGNATURE

HEAD OF THE DEPT.

(APPROVING AUTHORITY) NOTE : i- All leave application forms should be submitted to Pers. Dept. prior to availing the leave.
ii- All columns should be filled-in by the applicant.

/09/2008 Date

Dy. Manager Prepared By

HOD,P&A Approved By

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