Ref # HR-204/090/01

University of Management and Technology

LEAVE APPLICATION FORM
Employees Name: _____________________________________ Employee Code:
Designation: __________________________________________________________________________
Department / Office:

School / Institute:

Leave Type:

FULL

From: __

HALF

To: _____________

SHORT

No. of Days (s) / Hours (s): _ _______

Leave Category:
Casual /Sick*
_____________________

Earned

Maternity

Any Other

Reason:
Applicants Signature:

___________________

Date:

Officiating Officers Name:

Officiating Officers Signature: ________________________
Date:___________________

RECOMMENDATION
CoD / Immediate In-Charge: ________________________________

Date: __________________

Dean / Director/ Head of Support Office: _____________________

Date: __________________

FOR OFFICE USE ONLY

Received By:
Leave Record

_________________________

Date: ___________________

Casual / Sick

Earned

Previous Balance
On This Form
Current Balance

Head OHR:

_________________________

Date: _____________________

Rector:

__________________________

Date: _____________________

Remarks: ___________________________________________________________________________

Office of Human Resources

University of Management and Technology

*In Case of Sick Leave for more than three days, a valid medical certificate must be attached.

Office of Human Resources