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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): 2017 Carry Forward
2018 Entitlement
A L
Due to (reason) Previous Leave
n e
Taken
n a
I will be in the area of u v No. of Leave
a e Apply
In case of emergency please contact: l Balance of
Annual Leave
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:

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