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  • Leave Request Form

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    Charlie Quiped
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    Original Title

    LEAVE REQUEST FORM

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    © © All Rights Reserved

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    3 views1 page

    Leave Request Form

    Uploaded by

    Charlie Quiped

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    LEAVE REQUEST FORM LEAVE REQUEST FORM LEAVE REQUEST FORM

    DATE FILED: _______________________ DATE FILED: _______________________ DATE FILED: _______________________

    NAME: ___________________________ NAME: ___________________________ NAME: ___________________________


    (LAST) (LAST) (LAST)
    ___________________________ ___________________________ ___________________________
    (FIRST) (FIRST) (FIRST)
    ___________________________ ___________________________ ___________________________
    (MIDDLE) (MIDDLE) (MIDDLE)
    OFFICE: __________________________ OFFICE: __________________________ OFFICE: __________________________
    POSITION: ________________________ POSITION: ________________________ POSITION: ________________________
    NATURE OF LEAVE: NATURE OF LEAVE: NATURE OF LEAVE:
    ( ) VACATION ( ) VACATION ( ) VACATION
    ( ) SICK ( ) SICK ( ) SICK
    ( ) SPECIAL LEAVE PREVILEGE ( ) SPECIAL LEAVE PREVILEGE ( ) SPECIAL LEAVE PREVILEGE
    ( ) MATERNITY ( ) MATERNITY ( ) MATERNITY
    ( ) PATERNITY ( ) PATERNITY ( ) PATERNITY
    ( ) FORCED LEAVE (FL) ( ) FORCED LEAVE (FL) ( ) FORCED LEAVE (FL)
    ( ) COMPENSATORY TIME OFF (CTO) ( ) COMPENSATORY TIME OFF (CTO) ( ) COMPENSATORY TIME OFF (CTO)
    INCLUSIVE DATES OF LEAVE: INCLUSIVE DATES OF LEAVE: INCLUSIVE DATES OF LEAVE:
    _________________________________ _________________________________ _________________________________
    NO. OF DAYS: ______________________ NO. OF DAYS: ______________________ NO. OF DAYS: ______________________
    FOR CHRMO USE: FOR CHRMO USE: FOR CHRMO USE:
    ACTION TAKEN: ____________________ ACTION TAKEN: ____________________ ACTION TAKEN: ____________________
    BY/DATE: _________________________ BY/DATE: _________________________ BY/DATE: _________________________
    LEAVE REQUEST FORM LEAVE REQUEST FORM LEAVE REQUEST FORM

    DATE FILED: _______________________ DATE FILED: _______________________ DATE FILED: _______________________

    NAME: ___________________________ NAME: ___________________________ NAME: ___________________________


    (LAST) (LAST) (LAST)
    ___________________________ ___________________________ ___________________________
    (FIRST) (FIRST) (FIRST)
    ___________________________ ___________________________ ___________________________
    (MIDDLE) (MIDDLE) (MIDDLE)
    OFFICE: __________________________ OFFICE: __________________________ OFFICE: __________________________
    POSITION: ________________________ POSITION: ________________________ POSITION: ________________________
    NATURE OF LEAVE: NATURE OF LEAVE: NATURE OF LEAVE:
    ( ) VACATION ( ) VACATION ( ) VACATION
    ( ) SICK ( ) SICK ( ) SICK
    ( ) SPECIAL LEAVE PREVILEGE ( ) SPECIAL LEAVE PREVILEGE ( ) SPECIAL LEAVE PREVILEGE
    ( ) MATERNITY ( ) MATERNITY ( ) MATERNITY
    ( ) PATERNITY ( ) PATERNITY ( ) PATERNITY
    ( ) FORCED LEAVE (FL) ( ) FORCED LEAVE (FL) ( ) FORCED LEAVE (FL)
    ( ) COMPENSATORY TIME OFF (CTO) ( ) COMPENSATORY TIME OFF (CTO) ( ) COMPENSATORY TIME OFF (CTO)
    INCLUSIVE DATES OF LEAVE: INCLUSIVE DATES OF LEAVE: INCLUSIVE DATES OF LEAVE:
    _________________________________ _________________________________ _________________________________
    NO. OF DAYS: ______________________ NO. OF DAYS: ______________________ NO. OF DAYS: ______________________
    FOR CHRMO USE: FOR CHRMO USE: FOR CHRMO USE:
    ACTION TAKEN: ____________________ ACTION TAKEN: ____________________ ACTION TAKEN: ____________________
    BY/DATE: _________________________ BY/DATE: _________________________ BY/DATE: _________________________

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