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LEAVE APPLICATION

Date: -...……/…..…/………
Name of Employee: ………………………………………………….…………………….………………………………...
Father’s Name: …………………………………………………………………………….…………………………………….
Employee No: ….......................................Designation: ..........................................................
Location:QLM – MAO Rail Doubling Project, Goa.
Date of Joining Company: ………………………………..…………………….……………………………………………
Leave from: ……………….………………….…..……......To:………..………..…………………………………………
Type of Leave: ...……………………………………………………………………………………...……………..……………
Emergency Contact No & Address during leave: ………………..………………………..….…….…………….
…………………………………………………………………..………………………………………………………….…………….
……………………………………………………………………………………………………………………………………………..
Reasons: …………………………………………………..……………………….………………………………….………………
………………………………………………………………………………………………………………………………………………

………………………………………………… ..…………………………………………………
Signature of Applicant with date Signature of Sanctioning Authority

QLM- MAO Rail Doubling GOA


Project

FOR OFFICIAL USE ONLY


Leave applied: ……………………………………….. Leave Sanctioned: …………………………………
Leave Status: ………………………….Credited: ……………………….. Balance: …………..…………..

Feedback Infra Private Limited


H.O. Gurgaon.

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