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LEAVE APPLICATION Name ____________________________Designation______________________ Number of Leave[s]availed: Current month_________Last month ___________ Total leaves availed in the year:

CL _______________ others _______________ Nature of Leave to be availed: Casual Leave [CL] Duty Leave [DL] ____________ Number of Leave[s] required __________ from ___/__/______ to __/___/____ Reason for Leave[s] ________________________________________________ [FOR ACADEMIC STAFF ONLY] Details of your Session[s]/work during the leave[s]
Date Time of the session Subje Suggested work to ct be done Name and Sign. Of Assignee

Signature of Applicant Date:

Signature of HOD Date:

[FOR OFFICE USE ONLY] Leave Sanctioned Remark [if any] YES/ NO _______

Signature of the Chairman/Director

Date:

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