LEAVE APPLICATION

Name: Department:

Reason: Designation:

Date of Commencement of Leave: Date of resuming duty:

Address & Telephone No. during the Leave period:

(If applicable)

Date and signature of applicant:

Number of day’s leave to credit:

Remarks if any:

Date & Signature of HR Staff:

(Up to 3 days)

Recommended __________ days from: to:

Not recommended for (reasons):

Authorised / Unauthorised Leave:

Date & Signature of the DIC / Authority:

(For more than 3 days)

Sanctioned ____________ days from: to:

To resume duty on:

Leave not sanctioned for (reason):

Authorised / Unauthorised Leave:

Date & Signature of the DIC / Authority / Director: