ARAB TANKER SERVICES and CONTRACTING LLC

APPLICATION FOR LEAVE

REF.NO.: ATS/AFL/___/___ DATE APPLIED: ___________________
Year /S.No. Page : 1/1
*Rev. 10 (Oct 2019) Retention Period : 3 Years
HOME LEAVE: ENCASHMENT: CASUAL LEAVE: SICK LEAVE: CHANGE WORK TIME:

NOTE: In case of sick leave, medical certificate should be attached. Otherwise, leave application is automatically considered
as casual leave. Change Work Time must be approved by GM.

NAME: CODE NO: SECTION:

RANK :

ADDRESS WHILE ON LEAVE: EMERGENCY VOICE CONTACT NO.*

REQUESTED
DUE DATE PAID: days UNPAID: days TOTAL:
LEAVE DAY
LEAVE COMMENCE WORK ON:
FROM: TO:
SCHEDULE
Reason for applying for unpaid leave days/Change Work Time:

Management Comment:
______________________________________________________________________________ _______________
Immediate Mgr
_______________
G.M
REQUESTED FLIGHT BOOKING
FLIGHT DETAILS
DESTINATION DATE AIRLINE FLIGHT ETA ETD

MANAGEMENT APPROVAL
EMPLOYEE ADMIN/HR
PROJECT MANAGER GENERAL MANAGER MANAGING DIRECTOR

Name: Danny Rose Name: Mr. Hiroto Shimozono Capt. Akihiro Shimozono
Date: Date: Date: Date: Date:

FOR OFFICE USE ONLY

ADMINISTRATION DIVISION
Incharge _______________________ Date : ___/___/___
1.) Before Approval Checklist: Ms. Danny Rose

Expiry dates of the following documents:

Passport ______ / ______ / ______ Security Pass ________ / _________ / ______
Residence Visa ______ / ______ / ______ Labour Card ________/ _________ / _______

2.) Before Departure Checklist Incharge _______________________ Date : ___/___/___

Received & Delivered the following documents :
Offshore Security Pass Received Delivered Passport with passport security arrangement
Labour Card Received
Remarks :
Visa Cancellation due to ________________ Resignation End of Contract Termination Other: ___________
Labour office _____ / ______ / _____
Labour Cancellation Certificate (Airport) _______ / ________ / ________ Immigration _______ / ________ / ______

\\server\Working drive\All ATS Forms\Application for Leave

* Form Rev. 08 (Dec. 2014) ARAB TANKER SERVICES
Page : 2/2
HOME LEAVE CASUAL LEAVE SICK LEAVE ENCASHMENT END OF CONTRACT

FOR OFFICIAL USE ONLY

Seafarers Division
In-Charge _________________ Date: ______ / ______ / _____
1. BEFORE APPROVAL CHECKLIST

Confirmed Leave due date : ________ / _______ / ________

Leave due date adjusted _________ days due to Casual Leave ______ days
Sick Leave _________ days Others _____________ TOTAL : ________ days

Remarks: _______________________________________________________________________________
________________________________________________________________________________________

2. BEFORE DEPARTURE CHECKLIST

In-Charge _________________ Date: ______ / ______ / _____

a. Essential Information
Personal Key Hand-Over Verification by Master & Operations Mgr.
Hand-Over Certificate/Note

Completed satisfactorily Incomplete, note the remark

b. Advise Flight Schedule to the Agent Pearl Maritime Jenar Big Dipper
c. *Voice Contact No., Confirmed by the secretary date____/____/____ at____________:_________hrs.
*Contact Person Mr./Ms.___________________________ Relation with employee*_____________
Remarks: ______________________________________________________________________________
________________________________________________________________________________________
3. AFTER DEPARTURE CHECKLIST
In-Charge _________________ Date: ______ / ______ / _____
Employee Departure
Employee's Actual Leave
Commenced from __________________________ Schedule of Resumption : _____________
with Under Service Over Service ____________ days to be adjusted to the next duty.

Remarks : ______________________________________________________________________________
_______________________________________________________________________________________

Accounting Section
In-Charge _________________ Date: ______ / ______ / ____
1. BEFORE APPROVAL CHECKLIST

Employment Guarantee Dhs. ______ Available Employment Guarantee not available made loan

Loan Balance Dhs. _________________Transfer to : __________________ __________

( Name of Guarantor ) (Code No.)
No Loan Balance Passport Security Arrangement Provided
Remarks: _______________________________________________________________________________
________________________________________________________________________________________
2. BEFORE DEPARTURE CHECKLIST In-Charge _________________ Date: ______ / ______ / _____

Telephone Bill settlement completed Air Ticket delivered to crew Seafarer Incharge
Receipt of Settlement and due Administration Section
Confirmation of Essential Information One Way Air Ticket
by Operations Manager Two Way Air Ticket
Leave schedule prepared Return date fixed on ________
Salary settlement prepared Return Open ticket
Remark : _______________________________________________________________________________
_______________________________________________________________________________________
\\server\Common Data\All ATS Forms\Application for Leave.xls
ble made loan