Employee's Copy

PERSONAL LEAVE FORM

Date Filed: TYPE OF LEAVE FOR HR-BENEFITS USE ONLY
Name: SIL - Vacation Leave Leave Balances Type Total
Position: SIL - Sick Leave Previous Balance
Client Name: Maternity Leave (Less: this leave
Paternity Leave Balance to date
Inclusive Date/s of Leave: Leave w/o pay No. of days w/pay
Days of Leave: No. of days w/o pay
Date of Return:
Remaining SIL:
Reason:
Review / Posted by:
I have given proper notice to all that I will be out of the office for the period
of the time listed above and have made arrangement for coverage of all my
office responsibilities.

Approvals: Aprroved Denied

___________________________________
EMPLOYEE’S SIGNATURE

________________________ _________________________ _________________________ _________________________

Immediate Head HR & Operations Manager Managing Director HRAD Health & Benefits

HR Copy

PERSONAL LEAVE FORM

Date Filed: TYPE OF LEAVE FOR HR-BENEFITS USE ONLY
Name: SIL - Vacation Leave Leave Balances Type Total
Position: SIL - Sick Leave Previous Balance
Client Name: Maternity Leave (Less: this leave
Paternity Leave Balance to date
Inclusive Date/s of Leave: Leave w/o pay No. of days w/pay
Days of Leave: No. of days w/o pay
Date of Return:
Remaining SIL:
Reason:
Review / Posted by:
I have given proper notice to all that I will be out of the office for the period
of the time listed above and have made arrangement for coverage of all my
office responsibilities.

Approvals: Aprroved Denied

___________________________________
EMPLOYEE’S SIGNATURE

________________________ _________________________ _________________________ _________________________

Immediate Head HR & Operations Manager Managing Director HRAD Health & Benefits