Form 10.

2 - Leave Request Form

Leave Request
:Date

Full Name
96
.Employee ID No
:Part 1 Leave Type
Paid:

□ Annual vacation □ Childbirth Leave □ Hajj Pilgrimage Leave □ Death of a Relative Leave

□ Marriage Leave □ Maternity Leave □ Examination Leave □ Sick Leave

Unpaid:

□ Emergency

□ Other (please specify & provide the necessary documents):

:Part 2 Leave Information

Last Working Day Return to Work Day Duration of Leave (days)

:Part 3 Emergency Contacts

Name Telephone Address
Part 4 Ticket(s) Entitlements (As per Contract)
Approved Dependents Ticket(s) Entitlements

) ( Adults ) ( Yes
Child ( ) No ( )
Travel Sector Ticket(s) Class
From:________ To:________
Economy Business First Class
One Way Return
Visa
Exit Re-Entry Exit Only Others
Part 6 Employee’s Signature and Approval

Employee’s Signature: …..…..…………… Department Manager’s Signature:………………

Date: …../…../…………. Date: …../…../………….

Replacement Name:…………………………………..Replacement signature:………………….Date:……/…../…………

Part 7 HR and Administration Use Only
Days Eligible Vacation Earned to No. of Days Balance of Total Number of Days Remaining
Annually Date Used Unused Date Days Requested After This Vacation

HR Manager’s Signature:………………………
Date: …../…../………….
Original: Employee FileBNM

March 7, 2024 1 Developed by HR Dept.