LEAVE APPLICATION

Name:
_________________ Designati __________________
______ on: ___

From: ________ To: ___________ Nature of Leave: Casual Sick Short Leave
* In case of station leave: a. Leaving Station on: _____________ Dated: ___________
b. Coming Back on: ______________ Dated: ___________
In case of Short Leave: Leaving from: __________ am/pm To: _________ am/pm
Reasons for leave _____________________________________________________________
Name of Alternative Assigned: ___________________ Signature: ___________________
Date: _____________ Time: _________ Signature of Applicant: ____________
For Official Use
Leave Record
Type of leave
Recommended/ Not Recommended
Availed Balance

Current Month
Signature: ______________ Designation: ____________
Current Year

Approved: ___________

LEAVE APPLICATION
Name: _______________________ Designation: _____________________

From: ________ To: ___________ Nature of Leave: Casual Sick Short Leave
* In case of station leave: a. Leaving Station on: _____________ Dated: ___________
b. Coming Back on: ______________ Dated: ___________
In case of Short Leave: Leaving from: __________ am/pm To: _________ am/pm
Reasons for leave _____________________________________________________________
Name of Alternative Assigned: ___________________ Signature: ___________________
Date: ________ Time: _________ Signature of Applicant: _______________
For Official Use
Leave Record
Type of leave Availed Balance
Current Month Recommended/ Not Recommended

Current Year
Signature: ______________ Designation:
____________

Approved: ___________