APPLICATION FOR LEAVE

Name: Filling Date: 1/14/2022

Leo V.Galve
(Signature over Printed Name)

Number of days absent (include fraction of a day):

FROM: DATE: 15-Jan-22 TO: DATE: 15-Jan-22

Reason(s) for Absence: Feverish

Leo V.Galve
Noted By: Approved By:
Signature over Printed Name / Date Signature over Printed Name / Date
(To be filled up by Admin/Acctg.:)
Charge to: (please encircle applicable leave)
VL ML/PL Leave credits as of:
/ SL CL Current earned:
BL AWOL Remaining:
EL AWOP FL-
 FL-AD02 (LF)

ION FOR LEAVE

15-Jan-22

Approved By:
Signature over Printed Name / Date

FL-AD05 (SW) ver 0