VIVA COMMUNICATIONS, INC.

EMPLOYEE LEAVE APPLICATION FORM

NAME : DATE FILED:
__________________________________ __________________________
JOB TITLE DEPARTMENT :
__________________________________ __________________________

TYPE OF LEAVE NO. OF DAYS _____

Sick Leave FROM _______________
Vacation leave TO __________________

REASON

EMPLOYEES SIGNATURE FOR HRD USE

_____________________ Leave Credit Status
VL SL Others Remarks
w/ Pay
Present Status
NOTED BY: Less: Leave Applied w/out Pay
_____________________ Balance
Immediate Superior / Department Head
Data Recorded By ____________________________

Accomplish in two (2) copies: HRD

EMPLOYEE