HRD Copy

NAME OF EMPLOYEE: _______________________________________________________________

DEPARTMENT/GROUP: _________________________________________ DATE: ______________

Please be informed that the above-mentioned employee is being authorized to leave the Bank premises for the following reason/s

PURPOSE : ________________________________________________________________________
________________________________________________________________________

Time of Departure from place of work ________A.M./P.M.

Expected time of arrival ________A.M./P.M.
Is no longer expected to return
(mark “X” on blank if this line applies) ________

Authorized by:

_________________________
Department/Group Head
(Printed Name & Signature)