LEAVE APPLICATION FORM

HR Department
Date of application : Annual Leave 8 or 12 or 16
Entitlement
I, wish Medical Leave 14 or 18 or 22
to apply leave (s) from Entitlement
to
Total no. of day(s): due to Type of Leave No. of Days
Annual Leave
I will be in the area of Balance of Annual
Please call in case of Leave Day(s)
emergency. Medical Leave
Balance of Medical
Signature, Leave Day(s)
Compassionate
Leave
Matrimony Leave
Paternity Leave
Maternity Leave
Emergency Leave
Unpaid

HR Department :
Verified By,

Signature
Name:
Date:

Approved By,

Signature
Name:
Date:
 LEAVE APPLICATION FORM

Date of application : HR Department

Annual Leave
8 12 16
I, Entitlement
Medical Leave
14 18 22
wish to apply leave (s) from Entitlement
to
Type of Leave No. of Days
Total no. of day(s): Carry Forward Leave
Previous Leave
Due to (reason) Taken
No. of Leave
I will be in the area of Apply
Balance of Annual
In case of emergency please contact: Leave Day(s)
Medical Leave
Balance of Medical
Attached: Doctor's certificate Leave Day(s)
(if any) Others (please specify): Compassionate
Leave
Signature, Matrimony Leave
Paternity Leave
Maternity Leave
Emergency Leave
No Pay Leave

HR Department :
Verified By,

Signature
Name:
Date:

Approved By,

Signature
Name:
Date:
 LEAVE APPLICATION FORM

Date of application : HR Department

Annual Leave
8 12 16
I, Entitlement
Medical Leave
14 18 22
wish to apply leave (s) from Entitlement
to
Type of Leave No. of Days
Total no. of day(s): A 2017 Carry Forward
n 2018 Entitlement
n
Due to (reason) u Previous Leave
a Taken
l
I will be in the area of No. of Leave
L Apply
e
In case of emergency please contact: a Balance of
v Annual Leave
e
Attached: Doctor's certificate Medical Leave
(if any) Others (please specify): Balance of Medical
Leave Day(s)
Signature, Emergency Leave
No Pay Leave
Compassionate
Leave
Matrimony Leave
Please submit this application to HR Dept 7 days in advance. You are not Paternity Leave
entitled to go on leave until you receive an approval from the Director. Maternity Leave

HR Department :
Verified By,

Signature
Name:
Date:

Approved By,

Signature
Name:
Date: