HR F-02.

03 LEAVE APPLICATION FORM

SECTION A – TO BE COMPLETED BY EMPLOYEE

Name: Sheila R. Go

Location and contact number while on leave: Line Manager: Employee No:
#835 Tower 3 The Grass Residence, Bago Jerry Manalo SG6200654
Bantay St., Quezon City, 09565439208
Department: GSS IT

Note: Contact Details will only be used for emergency purposes. Please tick appropriate boxes and where applicable attach
supporting documentation i.e. medical certificate. Date range to be inclusive of first and last day of leave.

Annual Leave From To Full Pay Without Pay

Sick / Career’s Leave From 09/07/2021(4Hrs) To 09/08/2021(4Hrs) Full Pay Without Pay

Long Service Leave From To

Special Leave From To Full Pay Without Pay

Reason must be stated for Special Leave:

(Special Leave: i.e. Compassionate, Maternity/Paternity, Calamity)
Sick leave due to not feeling well.

Available Leave Balance (Sick / Annual): 16.50 / Day Verified with HR

Note: Email hr.phils@smec.com to confirm available Leave Balance

Total Number of Leave to be used: 1 / Day or / Hours (for Half Day)

Employee Signature: Date: 09/09/2021

SECTION B – TO BE COMPLETED BY SUPERVISOR

Is leave approved? Supervisor Signature: Date:

Yes No

SECTION C (ONLY IF REQUIRED) – TO BE COMPLETED BY TEAM / DEPARTMENT MANAGER

Is leave approved? Signature: Date:

Yes No

SECTION D – TO BE COMPLETED BY PEOPLE AND CULTURE (HR)

Date:
Leave Allocation:

Other Comments:

HR F-02.03: LEAVE APPLICATION FORM Page 1