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XYZ PVT. LTD.

LEAVE APPLICATION FORM

Name of the Employee :

Address :

Contact no(s). :

Department :

No(s). of Days :

Date of availing leave :

Reason :

Signature of Employee :

For official use only

Leave Approved (Yes/No) :

No(s). of days :

Leave approved from : To:

__________________
Authorized Signatory

Address company