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LEAVE FORM

TO BE FILLED BY THE APPLICANT NAME: EMPLOYEE ID. NO.: Number of days Nature of Leave CL PL SL CO RH DEPARTMENT:

Leave Status: PL.. CL.. SL. Period: Purpose of Leave: Contact Number during leave: Signature of employee : ________________. Date of application : ___________________ Recommendation from in-charge: Signature of In charge: _________________ Approved : Not approved : From __________________________To _______________________

Signature of HOD : _____________________________ TO BE FILLED BY HRD Available balance in Leave account: CL Entered in Leave Card: Admissibility: Signature of HR Dept. : Y Y PL N N SL CO

_______________________________

Leave year 1st April 31st March Salaried Staff : PL -21, CL -12 and SL -9 (In a leave year) Professional Fees / Stipend : PL 0, CL 12 and SL 0 (on consolidated pay) Staff working on part time basis : PL 0, CL 6 and SL 0 Any unauthorized Leave would be considered as Leave without Pay Employees can avail the Privilege Leave only after confirmation in service.

FORM F 10.21 Ver 09

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