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EMPLOYEE LEAVE FORM

EMPLOYEE INFORMATION

 Employee Name ……………………………………………………………………………


 Submission Date ……………………………………………………………………………
 Department …………………………………. Supervisor ……………………………
 Starting Date …………………………………. Ending date ………………………...

Type of leave Requested leave dates

 Annual leave …………………………......


 Sick leave ………………………………
 Maternal leave ……………………………...

LEAVE BALANCE

Leave information Balance


Annual Leave
Sick Leave
Maternal leave

Employee Signature ………………………………………………. Date


……………………………………………….

Supervisor: Approved: …………………………………………… Denied


……………………………………………

Supervisor’s Signature ……………………………………………. Date


………………………………………………

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