Doc.
No:QRD-AD-08
Page : 1 of 1
EMPLOYEE LEAVE APPLICATION FORM Rev.00
Date:06/04/2017
Division Administration
Department Human Resources
Document Title Employee Leave Application
To be submitted in personnel 30 days prior to the departure date for annual vacation
Name …………………………………………………………………. Department/Section ..............................................
Employee No. ................................................................................ Hire Date. .........................................................................
Job Title ................................................................. Tel. No. .....................................................................................
Applied Leave No. of Days No. of Days
Annual Total No. of Days
Emergency Last Working day:______________________
Unpaid
CONCERNED DEPARTMENT
Sick Leave (Paid In Advance) : Yes No
Others (Specify) Single Exit Re-Entry Visa:
Effective From : Company Account Personal Account
To : Air Tickets:
Resume Duty On : Company Account Personal Account
Contact During Leave : Destination:
Employee (Signature & Date) :
Departure Date Arrival Date
Supervisor (Signature & Date) :
Family Members:
Name Relationship Date of Birth
Manager (Signature & Date) :
Excess days remarks by Department Manager -
By Company By Employee
For excess day, fill excess days form
Current Year Balance Carried Over Total
Leave Days Applied Balance
Number of used days : Remarks :
HRD SECTION
Net Amount Payable
Ticket(s) Requirement (First Class) (Business Class) (Economy/ Class)
Yes No (Excursion/ Class)
Should unpaid leave be deducted from ESB
No of Days to be deducted from ESB -
Administration&Personnel (Signature & Date) HR Manager (Signature & Date)
Uncontrolled if printed