Leave Form

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LEAVE APPLICATION FORM

TO BE FILLED BY EMPLOYEE

Name: ____________________________________________________ Emp Code: ______________________

Designation: _______________________________________________ Department:______________________

Date of Joining: _____________________________________________ Location: _______________________

Type of Leave: Annual Sick Casual Maternity Compensatory Off

Leave Requested From: _________________ To __________________ Total No. of Days:_______________

Reason for Leave: ____________________________________________________________________________

___________________________________________________________________________________________

Address while on Leave: ______________________________________________________________________

__________________________________________________________ Tel No.: _________________________

_____________________ _____________________________ _____________________________


Employee Signature Immediate Supervisor’s Signature Sanctioning Authority’s Signature

FOR HR USE ONLY

Application received in HR on date: ______________

Type of Leave Entitlement Already Availed Balance Current Leave Remarks

Sick Leave

Annual Leave

Casual Leave

Maternity Leave

Leave Posted By: _____________________________________ Date: ________________________________

Verified by HR Representative: _________________________ Date: ________________________________

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