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Leave Application

________________________________________________________________________________________

Name: ___________________________________________________________ Emp. Id ______________

Team: __________________________________ Region/Location: ________________________________

This application should be submitted to immediate supervisor. Attach medical certificate for sick leave.
Check Type of Leave: No. of Days Period of Leave (From – To)
Casual
Privilege
Sick
Other (Specify)
Mailing Address while on Leave Reason for Leave

Applicant’s Signature

Supervisor
Check whichever is applicable: Signature(s) & Date
Approved
Rejected
Reason:

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Request for LTA and PL Encashment


__________________________________________________________________________________________
This request to be filled by applicant and submitted along with Leave Application to immediate supervisor.

Period of Leave (From-To) Name(s) Age Relationship Applicant Signature

Tick whichever is applicable: 1

Pay LTA due to me. 2

Pay me PL encashment 3 Supervisor Signature


for _____________ days
4

To be filled by Payroll
Pay Account Code Amount LTA Years
Leave Travel Assistance

Total amount (in words & figures)

August 2008

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