HUMAN RESOURCES DEPARTMENT

Leave Application Form

FHR03-08012020

Name: ___________________________________ Date Filed: __________________

Type Of Leave Applied For:

Vacation Leave Sick Leave
Date Time No. of Days Date Time No. Of Days

Undertime: Date: Time:

REASON:

Note: VL Application Should Be Submitted For Approval At Least 3 Days Before The Leave Is Taken.
To Be Replaced By:

Employee’s Signature: Approved By: Noted By:

________________________ __________________________ _________________________

**Please Do Not Write Below This Line

Vl Authorized Vl Excused Sl With Notice Approved With Pay ______ Days
Vl Unauthorized Vl Unexcused Sl Without Notice Approved W/o Pay ______ Days

Credits Current Less Available

VL _________________________
SL Authorized Officer

HUMAN RESOURCES DEPARTMENT

Leave Application Form

FHR03-08012020

Name: ___________________________________ Date Filed: __________________

Type Of Leave Applied For:

Vacation Leave Sick Leave
Date Time No. of Days Date Time No. Of Days

Undertime: Date: Time:

REASON:

Note: VL Application Should Be Submitted For Approval At Least 3 Days Before The Leave Is Taken.
To Be Replaced By:

Employee’s Signature: Approved By: Noted By:

________________________ __________________________ _________________________

**Please Do Not Write Below This Line

Vl Authorized Vl Excused Sl With Notice Approved With Pay ______ Days
Vl Unauthorized Vl Unexcused Sl Without Notice Approved W/o Pay ______ Days

Credits Current Less Available

VL _________________________
SL Authorized Officer