NORTHERN CORRIDOR IMPLEMENTATION AUTHORITY

LEAVE APPLICATION FORM L

SECTION A : TO BE COMPLETED BY APPLICANT
A
F
NAME KHALIDI BIN OTHMAN

EMPLOYEE NO. 039 HOME

CONTACT NUMBER
DESIGNATION MANAGER MOBILE 019 7700600

DIV/DEPT. AGRICULTURE INDUSTRY DIVISION

ADDRESS (during leave) NO.7, JALAN PAUH RIA 2, BANDAR BARU UDA

81200 JOHOR BAHRU

JOHOR

TYPE OF LEAVE APPLIED FOR (Please tick whichever is applicable)

ANNUAL LEAVE MATERNITY LEAVE

COMPASSIONATE LEAVE PATERNITY LEAVE

MARRIAGE LEAVE UNPAID LEAVE

MEDICAL LEAVE EMERGENCY LEAVE

X REPLACEMENT LEAVE OTHERS (please specify)

REASON FOR APPLICATION

Attending Meeting On Seed Production at 14.08.2009 (as per attached)

LEAVE RECORD

LEAVE TO COMMENCE FROM 8/16/2009 NAME OF RELIEF PERSONNEL TAKING PREVIOUS YEAR C/F 0 DAY(S)

NUMBER OF WORKING DAYS 1 days OVER DUTIES WHILE AWAY (IF ANY) CURRENT YEAR 0 DAY(S)

TOTAL 0 DAY(S)

CURRENT YEAR TAKEN 0 DAY(S)

THIS APPLICATION 0 DAY(S)

SIGNATURE OF APPLICANT SIGNATURE OF RELIEF PERSONNEL BALANCE 0 DAY(S)

DATE OF APPLICATION 13.8.2009

SECTION B : TO BE COMPLETED BY SUPERIOR
Recommended by Head of Unit / Department / Division
Approved by Head of Department / Division / CEO

NAME NAME HJ. ABU BAKAR BIN L. MAN

DESIGNATION DESIGNATION SENIOR VICE PRESIDENT

DATE DATE

SECTION C : TO BE COMPLETED BY HR
DATE RECEIVED RECEIVED BY NAME

DESIGNATION
Compatibility Report for NEW LEAVE APPLICATION FORM
(Interim).xls
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