Jazan Refinery Project, EPC-13

LEAVE APPLICATION FORM (Rental Employee)

Joined Date : .... Submission Date : ...

Name : .. Company : .....

Designation : ......... Department ......

No. of Days Applied : .. No. of Days Approved :....

Full Day : Half Day :

Leave Start Date : ... Leave Completion Date :..

Contact Address :

..Tel. : ..

I am aware of companies rules and regulations that I should return back and join duty on or before the due date, failing
which company shall take appropriate action.

Approved & Forwarded by Signature of Applicant
Supervisor/Engineer/Dept.Manager
Department Head Approval & Request

Replacement Required : Yes / No

+
Whether to Re-assign to same site : Yes / No
+
.
Dept.Manager Signature

(For ADMIN Use Only)

.
(Mikio Oi) (Osamu Miyaji)
General Manager Admin Manager
NOTE
For any extension of leave concerned Project Incharge / Dept. Head to be informed & approved in advance. If Employee
+
does not rejoin on the due date, necessary action will be taken as per the Saudi Labor Law & the Hitachi Company Policy.