/

Leave Request While on Duty

2015/12/17

Date

0530

Employee Code

Employee Name

BSS

Job Title

Department
Permission Period:

1:30 to 5:00
)

( TO:

( From:

Reason

Employee's Signature

( )
( )

Date:

Signature:

This part should be completed by Human Resources:

)

( Period leave taken during the month of

Balance remaining in hours

Comment:

Direct Supervisor Comment:

Date:
:

Human Resources Manager:

Form No. HGHR 005