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Appendix VII-A

LEAVE APPLICATION FORM

EMPLOYEE INFORMATION

Name Designation
Department Employee ID
Base Station Date of Joining
Contact No. Email Address

LEAVE INFORMATION (to be filled by applicant)

Purpose:__________________________________________________________________________________________
___________________________________________________ From:__________________ To:__________________

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Leaves Entitled 10 20 - 10 - 90 03 - 40/15
Already Availed
Remaining Balance
Applied Now
Balance
Any Other Information:
* For Females

Signature of Applicant:__________________ Date:______________

Recommendations:

______________________________ _____________________ _________________ _________________

1.
Name Designation Signature Date

______________________________ _____________________ _________________ _________________

2.
Name Designation Signature Date

______________________________ _____________________ _________________ _________________

3.
Name Designation Signature Date

Approval:

_____________________________ _____________________ _________________ _________________

Name Designation Signature Date

VERIFIED & RECORDED BY HR DEPARTMENT

_____________________________ ____________________ __________________ __________________

Name Designation Signature Date