OFFICE OF THE PRESIDENT

MINISTRY OF INTERIOR AND COORDINATION OF NATIONAL GOVERNMENT

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Telegraphic address: “districter”

Email: dcchadado@gmail.com

The Deputy County Commissioner

Hadado Sub-County
HADADO

Thro,
Assistant County Commissioner

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APPLICATION FOR ANNUAL LEAVE

(To be submitted at least 30 days before the leave is due to begin)

1. I ………………………………………………………………P/no…..………………………….
Designation………………………………wish to apply for…….Days annual leave beginning
on………………to……………… . I have also……… days leave balance for the year
…………., the last leave taken by me was from ………… to …………
2. My leave address will be;
…………………………………
…………………………………
…………………………………
3. During the period of leave my salary should:-
a) Continue to be paid into my bank account.
b) Be paid at the following address:
………………………………….
………………………………….

c) Be included in the payroll of…………………………………………………………(station)

Note: For (a) and (b) it is conditional for an Officer to utilize at least one half of his/her annual
leave to qualify for free transport facilities.

As I am taking not less than one half of my annual leave due to me, I wish to receive my pay for
the month of …………………three days before the date of commencement.

I understand that I will require permission should I require to spend outside Kenya in terms of
Personnel Circular No.6 of 15th February 1967.

Signature of Applicant………………………………………………………
Date………………………………

PART II

To be completed by Head of Department / Deputy County Commissioner

a) Recommended. Arrangements can be made for the performance of the duties of the above
officer during his /her absence.
b) Not recommended for the following reasons.

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Delete (a) or (b)

Station…………………………………………………….
Signed……………………………………………………..
Date………………………………………………………..
Designation……………………………………………..

PART III

His/her duties will be performed by,

Name ……………………………………

Designation………………………………