LEAVE APPLICATION

Employees Name:
Department :

Vacation Leave without pay

Vacation Leave

Sick leave without pay

Sick Leave

Compassionate Leave

Annual Leave
Other, please specify
Period from

________________

____________ to ______________
(First day of leave)
(Last day of leave)

Total 1_ day/s and returning to work on:________________

HR USE ONLY
No. of days applied for ______
leave : _____________

Employees Signature:
Date

Total Balance of ___ Leave:

As of __________

Approved By:

-------------------------------------------------------------------------------------------------------------------------To: ____________________
Date:_____________________
RETURN TO APPLICANT
No. of days applied for ______
_____________
Period:
Total Balance of Annual Leave:
As of _____________

leave:

Verified By: