MINISTRY OF AGRICULTURE & FISHERIES
APPLICATION FOR VACATION LEAVE
NOTE: Application for vacation leave should reach the Permanent Secretary no later than four (4)
weeks before the beginning of the leave applied for.
Name of Applicant ……………………………………………………………………………………………………………………………………
(BLOCK LETTERS)
Office Stationed …………………………………………………….. Post/Grade ……………………………………………………….
Salary ……………………………………………………………… Contact Number (Local) ……..…………………………………………
Date and duration of last Vacation Leave ………………………………………………………………………………………………….
Period of leave now applied for ……………………………………………………………………………………………………………….
Permission being sought to proceed abroad? YES NO
If Yes, indicate proposed address ……………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………….
Contact Number (Overseas)…………………………………………….. Email address …………………….………………………….
No. of days Departmental Leave utilized since January 1 ………………………………………………………………………….
No. of days Sick Leave utilized since January 1 …………………………………….………………………………………………….
Leave pay to be sent to or collected by …………………………………………………………………………………………………….
…………………………………………………………….. ……………………………………………………..
Signature of Applicant Date
Arrangement proposed for the performance of duties ……………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………….
Leave: Recommended Not recommended
………………………………………………………………………..… ……………………………………
Name & Signature of Supervisor Date
…………………………………………………………………..…….. …………………………………..
Name & Signature Head of Division Date
Permanent Secretary,
The applicant is eligible for ……………………… ( ) days vacation leave, with effect from ……………………..
Full pay ……………………………………..……… No pay …………………………………..…………………………………
…………………………………………………………….. ……………………………………………………..
Human Resource Officer Date
Leave approved on the terms stated ……………………………………………………………………….
Permanent Secretary
Noted in: (1) Leave Register ……………………………………………………………………………
(2) Salaries Register …………………………………………………………………………
Form HRM&D-HRM 001 Page 1 of 1
Prepared by: Snr. Human Resource Officer Approved by: Snr. Dir. HRM&D
Date Issued: 2018-07-30 Revision #: 2.0 Date Revised: 2021-05-06
