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Leave Application Form

Name: _______________________________________________________ Employee ID: ________________

Department: ___________________ Designation: _________________________ Position: ___________________

Leave Applied for:

No. of Days: __________________

From Date: D/MM/YYYY To Date: D/MM/YYYY

Nature of Leave:

Casual Leave Medical Leave Monthly Leave

Annual Leave Leave Without Half Day Leave


Pay:

Short Leave

Reason(s): ___________________________________________________________________________________________

Task handover to:

Name: _________________________ Designation/Position: _______________________

Tasks Summary: _________________________________ Assignee Signature: __________________________________

________________________________________________

Applicant’s Signature: _____________________________

LEAVE POSITION
(To be filled by HRD before approval of Leave) APPROVAL

Types of Leave Entitled Availed Balance Approved

Not Approved due to______________


Casual Leave _______ _______ _______
Medical Leave _______ _______ _______ __________________________________

Responsible person for tasks:


Annual Leave _______ _______ _______ __________________________________
Monthly Leave _______ _______ _______

HRD: ________________________ Approved by HOD/Director: ______________________________


(Date & Signature) (Date & Signature)

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