POLYSTAR GENERAL SERVICES , INC.

82 Bernabe St. Annex 1618 Betterliving Subd., Paranaque City

Application for Leave/ Absences

Employee: ID No.: Date Filed:
Project/Department: Position: Date Hired:
Nature of Leave: Dates of Leave:
VL SL SIL LWOP CO (am/pm)If half Day
Reason of Leave: NOTE:

(please indicate specific reason)
1. SL of two (2) or more days will require attachment of Medical Certificate.
2. For VL and SIL availment, prior approval will be required. At least fifteen (15) working days.
3. For Leave of Absence Emergency in Nature, Employees are required to immediately ( two hours before the official time) notify
the superior and/or the Personnel Department. The leave will be filed immediately uppon the first reporting day from the leave
of absence and are required to secure back to work before proceeding to work station.

Recommended by: Approved By:

Employee Signature Over Printed Name Immediate Superior Signature Over Printed Name COO/HRAD
For Personnel Department Use Only
Leaves VL SL SIL LWOP PERSONNEL ACTION HRAD PAYROLL
Unused Leave Full Pay
Used Leave Without Pay
Balance Others
Employee's Copy

POLYSTAR GENERAL SERVICES , INC.

82 Bernabe St. Annex 1618 Betterliving Subd., Paranaque City
Application for Leave/ Absences
Employee: ID No.: Date Filed:
Project/Department: Position: Date Hired:
Nature of Leave: Dates of Leave:
VL SL SIL LWOP CO (am/pm)If half Day
Reason of Leave: NOTE:

(please indicate specific reason)
1. SL of two (2) or more days will require attachment of Medical Certificate.
2. For VL and SIL availment, prior approval will be required. At least fifteen (15) working days.
3. For Leave of Absence Emergency in Nature, Employees are required to immediately ( two hours before the official time) notify
the superior and/or the Personnel Department. The leave will be filed immediately uppon the first reporting day from the leave
of absence and are required to secure back to work before proceeding to work station.

Recommended by: Approved By:

Employee Signature Over Printed Name Immediate Superior Signature Over Printed Name COO/HRAD
For Personnel Department Use Only
Leaves VL SL SIL LWOP PERSONNEL ACTION HRAD PAYROLL
Unused Leave Full Pay
Used Leave Without Pay
Balance Others
HR's Copy

POLYSTAR GENERAL SERVICES , INC.

82 Bernabe St. Annex 1618 Betterliving Subd., Paranaque City
Application for Leave/ Absences
Employee: ID No.: Date Filed:
Project/Department: Position: Date Hired:
Nature of Leave: Dates of Leave:
VL SL SIL LWOP CO (am/pm)If half Day
Reason of Leave: NOTE:

(please indicate specific reason)
1. SL of two (2) or more days will require attachment of Medical Certificate.
2. For VL and SIL availment, prior approval will be required. At least fifteen (15) working days.
3. For Leave of Absence Emergency in Nature, Employees are required to immediately ( two hours before the official time) notify
the superior and/or the Personnel Department. The leave will be filed immediately uppon the first reporting day from the leave
of absence and are required to secure back to work before proceeding to work station.

Recommended by: Approved By:

Employee Signature Over Printed Name Immediate Superior Signature Over Printed Name COO/HRAD
For Personnel Department Use Only
Leaves VL SL SIL LWOP PERSONNEL ACTION HRAD PAYROLL
Unused Leave Full Pay
Used Leave Without Pay
Balance Others
Payroll's Copy