FARMER JAY’S (PRIVATE) LIMITED

LEAVE APPLICATION FORM

NAME.................................................. SURNAME..........................................................................

I.D NO.................................................. EMPLOYMENT NO...........................................................

JOB TITLE........................................... DEPARTMENT..................................................................

_____________________________________________________________________________________

NATURE OF LEAVE

Please tick where applicable and Manager should liaise with Human Resources records office before
approving leave.

LEAVE CLASSIFICATION BALANCE DAYS LEAVE CLASSIFICATION BALANCE DAYS

ANNUAL MATERNITY
COMPASSIONATE SICK

NO. OF DAYS TAKEN..........: FROM: ….............................. TO…..............................................

ADDRESS WHILE ON LEAVE …................................................................................................................

….............................................................................. CONTACT NO….....................................................

EMPLOYEE’S SIGNATURE.................................. DATE....................................................................

APPROVED/NOT APPROVED BY................................................. SIGNATURE.........................................

HEAD OF DEPARTMENT

AUTHORISED/N0T BY BY.............................................................. SIGNATURE...................................

HUMAN RESOURCES

_____________________________________________________________________________________
FOR HUMAN RESOURCES DEPARTMENT OFFICIAL USE ONLY

TOTAL NO. OF DAYS...................... NO. OF DAYS TAKEN..................... NO. OF DAYS LEFT.............................

ACTIONED BY…..................................... SIGNATURE............................. DATE..............................................