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PDF Format of Leave Forms

PDF Format of Leave Forms

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Published by: Jeevan Bhat on Mar 13, 2012
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06/01/2012

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ANNEXURE - VI

(See Byelaw 6.1)
H. R. SECTION
Applicatio !o" Ca#$al %ea&e
'o"( (a)
1.
2.
3.
4.
Name ________________________________________ Empl. Code __________
Designation __________________________ Section ______________________
Period of Casual Leave applied for ______ das !from _________ to _________"
#it$ permission to prefi%&suffi% Sundas and 'olidas on __________________.
(eason ___________________________________________________________
)ate * ++++++++++++++++++++++++ (Si,at$"e o! Applicat)
Re(a"-#
Casual Leave ta)en____________das.
Sanctioned
Hea. o! t/e )epa"t(et
Not Sanctioned
(eason* if not sanctioned
Aca.e(ic I-C/a",e A##ociate )ea
Re(a"-# o! t/e H.R. Sectio
Casual Leave for ________ das from ___________ to __________ sanctioned & refused.
Casual Leave +alance after deduction _________________________________________
(%ea&e Reco". Ic/a",e)
(HR Sectio)
000000000000000000000000000000000000
(eceived t$e application of S$ri&Smt.&,um.____________________________________
for casual leave for _______ das from ____________ to ____________ on _________.
Si,at$"e a. Na(e o! Recei&e"
o! t/e Applicatio.
1
H. R. SECTION
Applicatio !o" Optioal Holi.ay
'o"( (1)
1.
2.
3.
Name ________________________________________Empl. Code __________
Designation __________________________ Section ______________________
-ptional 'olida re.uired on ______________________________ on account of
________________________________________________________________.
)ate * ++++++++++++++++++++++++ (Si,at$"e o! Applicat)
Re(a"-# o! t/e Hea. o! )epa"t(et
-ptional 'olida ta)en ________________ da.
Sanctioned
Hea. o! t/e )epa"t(et
Not Sanctioned
(eason* if not sanctioned
A##ociate )ea Aca.e(ic I-C/a",e
Re(a"-# o! t/e H.R. Sectio
-ptional 'olidas on ____________________ sanctioned & refused.
-ptional 'olidas +alance after deduction _______________________.
(%ea&e Reco". Ic/a",e)
(HR Sectio)
000000000000000000000000000000000000
(eceived t$e application of S$ri&Smt.&,um.____________________________________
for -ptional 'olida for ____ das from ____________ to ____________ on ________.
Si,at$"e a. Na(e o! Recei&e"
o! t/e Applicatio.
2
H. R. SECTION
Applicatio !o" %ea&e
'o"( (c)
1. Name ________________________________________ Empl. Code __________
2. Designation ________________________ Section&/nit____________________
3. 0Nature of leave and period of leave re.uired __________________________
from ___________________ to ____________________
4. (eason ___________________________________________________________
1. 2ddress during a+sence of leave _______________________________________
0Earned Leave & Commuted Leave & Sic) Leave !'alf Pa"00 & Leave on Loss of Pa
3. 004edical Certificate is essential if leave ta)en on medical grounds.
)ate * ++++++++++++++++++++++++ (Si,at$"e o! Applicat)
Sanctioned
Re(a"-# o! t/e Hea. o! )epa"t(et
Not Sanctioned
S$ri&Smt.&,um. _________________ ma
please +e appointed as su+stitute to $old
additional c$arge of t$e post of&to act at
_____________ during t$e period of leave.

Hea. o! t/e )epa"t(et
(eason* if not sanctioned
Aca.e(ic I-C/a",e A##ociate )ea
Nature of Leave
EarnedLeave
Commuted Leave
Sic) Leave&'alf pa
Leave
Leave on Loss of Pa
Leave
-pening
5alance
Re(a"-# o! t/e H.R. Sectio
No.of 6rom 7o
das
ta)en
5alance
Closing
Sanctioned&
(efused
8t is certified t$at S$ri&Smt.&,um._______________________ #ould $ave continued to officiate as
_______________ +ut for proceeding on leave.
2ppointment of S$ri&Smt.&,um.__________________ to act as & to $old additional c$arge of post of & as
su+stitute ________________ ma please +e approved during t$e said period of leave.
(%ea&e Reco". Ic/a",e)
(HR Sectio)
Re,i#t"a"
0000000000000000000000000000000000000000000
(eceived t$e application of S$ri&Smt.&,um.____________________________________
for ________leave for _______ das from ____________ to ____________ on _________.
Si,at$"e a. Na(e o! Recei&e"
o! t/e Applicatio.
3
H. R. SECTION
Applicatio !o" Co#$ltacy2Special %ea&e
'o"( (.)
1.
2.
Name _______________________________________ Empl. Code __________
Designation ________________________ Section&/nit____________________
3. No. of das___________ from _____________ to _______________
4.
1.
3.
Consultanc Das !12 das"& Special Leave !11 das"
2ddress&Contact during a+sence of leave for t$e a+ove mentioned period
__________________________________________________________________
Documents 2ttac$ed _________________________ 2pproved !9es&No"_______
:. 2mount s$ared #it$ /niversit ! 9es& No" E%empted !9es&No"
)ate * ++++++++++++++++++++++++ (Si,at$"e o! Applicat)
Sanctioned
Re(a"-# o! t/e Hea. o! )epa"t(et
Not Sanctioned
S$ri&Smt.&,um. _________________
ma please +e appointed as su+stitute
to $old additional c$arge of t$e post
of&to act at _____________ during
t$e period of leave.
Hea. o! t/e )epa"t(et
(eason* if not sanctioned
A##ociate )ea Aca.e(ic I-C/a",e
Nature of Leave
Consultanc das
Special Leave
Re(a"-# o! t/e H.R. Sectio
-pening No.of 6rom 7o
5alance das
ta)en
Closing
5alance
Sanctioned&
(efused
(%ea&e Reco". Ic/a",e)
(HR Sectio)
Re,i#t"a"
000000000000000000000000000000000000
(eceived t$e application of S$ri&Smt.&,um.____________________________________
for __________for _______ das from ____________ to ____________ on _________.
Si,at$"e a. Na(e o! Recei&e"
o! t/e Applicatio.
4
H. R. SECTION
Applicatio !o" O$t.oo" )$ty2)$ty %ea&e
'o"( (e)
1.
2.
Name _______________________________________ Empl. Code __________
Designation ________________________ Section&/nit____________________
3. No. of das___________ from _____________ to _______________
4.
3.
:.
-utdoor Dut &Dut Leave 1. (eason;_________________________________
2ddress&Contact during a+sence of leave for t$e a+ove mentioned period
__________________________________________________________________
Documents 2ttac$ed _________________________ 2pproved !9es&No"_______
)ate * ++++++++++++++++++++++++ (Si,at$"e o! Applicat)
Sanctioned
Re(a"-# o! t/e Hea. o! )epa"t(et
Not Sanctioned
S$ri&Smt.&,um. _________________
ma please +e appointed as su+stitute
to $old additional c$arge of t$e post
of&to act at _____________ during
t$e period of leave.
Hea. o! t/e )epa"t(et
(eason* if not sanctioned
Aca.e(ic I-C/a",e A##ociate )ea
Nature of Leave
-utdoor Dut
Dut Leave
No.of
das
ta)en
Re(a"-# o! t/e H.R. Sectio
6rom 7o (eason
Sanctioned&
(efused
(%ea&e Reco". Ic/a",e)
(HR Sectio)
Re,i#t"a"
000000000000000000000000000000000000
(eceived t$e application of S$ri&Smt.&,um.____________________________________
for -D&Dut leave for _______ das from ____________ to __________ on _________.
Si,at$"e a. Na(e o! Recei&e"
o! t/e Applicatio.
1

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