LEAVE APPLICATION FORM

This form must be filled in by the employee whenever he/she is absent from work whether the reason is
vacation, granted leave, absence due to illness or any other reason. When the reason for absence is illness,
the form should be completed after return to work.

When a leave of absence is planned, this form is to be considered an application for leave, vacation, etc. at
the specified dates and must be handed to the line manager in due time for approval.

Applicant: Emp. ID: Section Name/No.

Reliever: Emp. ID: Section Name/No.

Indicate Type of Absence: X

Annual / Contractual Leave

Time in Lieu
Sick Leave - Please attach relevant documents
X Unpaid Leave – Please specify the reason under comments
Others: Please specify :

Leave Period: From: To: Number of Days :

Additional Comments:

Contact Details during leave period : Mob: Email Id :

This form is to be completed by the applicant, signed by the Line Manager and the original with supporting
documentation is to be attached to the applicant’s time sheet.

Applicant Signature: Date:

Line Manager Signature: Date:

Finance Comments:

______________

DNV GL