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and General Merchandising

52 Pallua Road Ext.Pallua Norte, Tuguegarao City 3500 Philippines


Telephone No. (078) 844-5373 Cell# 09178073481
E-mail Address:​sanjacintoconst@yahoo.com

LEAVE REQUEST FORM

Name:
Position:
Project Assigned:

Type of Request (please tick one):

⬜Sick Leave

⬜Vacation Leave

Dates affected by leave (specify hours if not full days):​__________________________

Remarks:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

I hereby declare that all the information stated above are accurate and true.

____________________________
Signature over Printed Name of Employee

____________________________
Signature over Printed Name of Supervisor

_________________________________________________________________________
TO BE FILLED UP BY HR ONLY

Number of leaves available:

Sick: ____/5 Vacation: ____/5

Disposition of Request:

⬜Approved- No loss of pay


⬜Approved- Deduction applies
⬜Not Approved

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