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Corporate Office: House # 25, Road # 34, Gulshan # 02, Dhaka - 1212.

Leave Request Form

Employee/Face ID No : 99953 Date : 14-10-2019

Name : Md.Mominul Islam

Company : Baraka Engineers Ltd

Position : Executive Director Department : Block

Nature of Leave : (Please Mark ) : Annual ✔ Casual Sick Late Adjustment

From : 15-10-2019 To : 15-10-2019 ( 01 ) Day(s)

Justification : Personal Issue

Leave Address :

Permanent Address : Dhaka.

Emergency Contact Number :

Contact Number : 01950005002 Length of Service :

Leave Without Pay/Absence : Leave Availed (Paid) :

Applicant’s Signature Signature


Head of Human Resource Department

Departmental Approval Approved By


Head of the Department’s Chairman/Managing Director/
Supervisor or Manager Director (Admin)

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