PUNCAK MEDINA SDN BHD

Lot 5 & 6, Lorong Makat Industrial Estate, Off Jalan Kolombong

88450, Kota Kinabalu, Sabah
Tel : 088-386786 Fax : 088-430787

LEAVE APPLICATION FORM

PART A: BY EMPLOYEE
NAME : POSITION :
EMPLOYEE NO : LOCATION / DEPT :
DATE JOIN : DATE CONFIRM :
LEAVE DATE FROM : TO : NO OF DAY :
TYPE OF LEAVE APPLIED ANNUAL LEAVE UNPAID LEAVE SICK LEAVE
EMERGENCY LEAVE MATERNITY LEAVE PATERNITY LEAVE ABSENT
REASON FOR LEAVE APPLIED :
STAFF RELIEVING :
TASK HANDOVER :

(SIGNATURE) (SIGNATURE)

EMPLOYEE NAME : RELIEVING STAFF NAME :

DATE APPLIED : DATE :

PART B: BY HUMAN RESOURCE DEPT

ANNUAL LEAVE SICK LEAVE REMARKS
B/F ENTITLED TOTAL TAKEN BALANCE ENTITLED TAKEN BALANCE

LEAVE HISTORY
LEAVE TYPES JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC TOTAL
ANNUAL LEAVE
SICK LEAVE
UNPAID LEAVE
ABSENT
EMERGENCY LEAVE
MATERNITY LEAVE
PATERNITY LEAVE
TOTAL
LEAVE APPROVED LEAVE NOT APPROVED
(SIGNATURE) (SIGNATURE)

HEAD OF DEPARTMENT MANAGING DIRECTOR

DATE : DATE :

PART C: EMPLOYEE RECORD LEAVE DATE

STAFF NAME : FROM : TO : NO OF DAYS :
LOCATION :
ANNUAL LEAVE SICK LEAVE REMARKS
APPROVED
B/F ENTITLED TOTAL TAKEN BALANCE ENTITLED TAKEN BALANCE
NOT
APPROVED
LEAVE HISTORY
LEAVE TYPES JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC TOTAL
ANNUAL LEAVE
SICK LEAVE
UNPAID LEAVE
ABSENT
EMERGENCY LEAVE
MATERNITY LEAVE
PATERNITY LEAVE
TOTAL

RECORD BY HR : DATE :