Leave Application Form
Employee Details:
Name of Employee: ________________________________________________________________
Employee ID #: __________________ Designation: _____________________________________
Department: ______________________________________________________________________
Leave Period:
From: ____/____/_______ To: ____/____/_______ Casual Sick Earned In Lieu of Without Pay
Reason: ___________________________________________________________________________
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:
______________________________________________________________________________________________
______________________________________________________________________________________________
___________________
Applicants Signature:
Date: ___/___/______
____________________________________
Applicant Reporting Authoritys Signature
Date: ___/___/______
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.