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Leave Application Form Form HR - I

SECTION - I For Applicant

• Staff Name: • Staff No.:

• Designation: • Date:

• Dept. / Section: • Date of Return to Work:

• Period of Leave: From ______________ To _______________ Total Days:


(first date of leave) (last date of leave)
• Type of Leave: Earned Casual Sick Un-paid
Applied:

• Reason of Leave:

• Responsible Person in my Absence:

• Applicant Signature: Date:

Contacts during leave:


Address: Email:
Phone:

• Clearance from Manager / Incharge if any other assignment is in hand:

Manager: Date:

SECTION -II Current Leave Balance

Entitlement of leave as on: Employee Date of Joining:________________

Earned Leave (Un-paid / Un-availed) :

Casual Leave (for the year):

Sick Leave (for the year):

Comments:

HR Department
SECTION -III For Recommendations & Approval

Type of Leave: Earned Casual Sick Un-paid


Approved:

Period of Leave: From To Total Days: _________


Approved:
(first date of leave) (last date of leave)

Recommended By: Approved By:

_____________________________
Line Manager / Reporting Officer RM / GM / TL

Date: _________________________ Date: _______________________

Note: i)Management reserves the right to call any employee on job in case of emergency.
ii) All Department Heads and General Manager (OPS) will get earned leave approval from MD.

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