HRD ID: ________

Leave Application Form

Employee Details:

Name of Employee: _____________________ALI UZAIR________________________________

Employee ID #: 998-12-1001 Designation: ____Coordinator Verification __________________

Department: _______________________Verification___________________________________

Leave Period:

From: 05 / 08 / 2021 To_:_21 /_08_/_2021_ Casual Sick Earned In Lieu of Without Pay

Reason: ___________________Diagnosed COVID Positive. (Reports Attached) __________.

Comments (To be filled by Reporting Authority):

1. Work in absence of the staff, assigned to other: Yes No

2. Approval granted for leave: Yes No

Additional Remarks / Comments:
______________________________________________________________________________________________
______________________________________________________________________________________________

_______________________ ____________________________________
Applicant’s Signature: Applicant Reporting Authority’s Signature
Date: _23_/ 08 / 2021 Date: / _/ 2021

Note:

1. Leave application should be submitted to the Human Resource Department duly signed by the concerned HOD before
Availing the leave. In case of emergency, application must be submitted immediately after joining the duty.

2. Kindly note that if application is NOT submitted on time, salary will be deducted accordingly.

3. In case of more than one Medical leave, medical certificate should be submitted along with Leave application.