LEAVE APPLICATION FORM

NAME COMPANY
DATE FILED DEPARTMENT

Vacation Leave Sick Leave Maternity Leave Paternity Leave Others:

TYPE OF LEAVE
[ ] [ ] [ ] [ ] _____________

PERIOD COVERED: ____________________________ NO. OF DAYS: ________________________________

REASON FOR LEAVE:

____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________

NOTE:

 The vacation leave should be previously applied for and approved by the department head and the HR Manager. Approval of
leave/absence must be obtained at least three (3) days in advance prior to the intended day of absence.

 The company will grant to sick leave with pay to employee who is genuinely sick and unable to report for work. A certification
(medical certificate) by a duly licensed physician is required in case of illness lasting for more than two days.

 Female employees are entitled to maternity leave with pay in accordance with existing labor laws/SSS law only up to four
st
deliveries. The employee should notify the employer of her pregnancy and probable date of her childbirth on the 1 trimester.

 A paternity for the first four (4) deliveries by his lawful wife is granted to every married male employee. It should be applied
seven (7) days prior to the expected date of delivery by the pregnant spouse.

 Any employee, who shall be deemed to have abandoned his/her work, shall be penalized with outright dismissal.
Abandonment may be construed should an employee: (a) failed to report for work for four consecutive days or more without
prior notice to and approval by the management, unless such failure to report for work and to give due notice are due to
justifiable reasons, or (b) failed to report for work for four consecutive days after the expiration of his official leave of absence,
without prior notice to and approval by Management, unless for justifiable cause.

__________________________________
Employee’s Signature

RECOMMENDATION / APPROVAL: APPROVED DISAPPROVED SIGNATURE DATE

DEPARTMENT / SECTION HEAD [ ] [ ] ____________ ____________

MANAGEMENT [ ] [ ] ____________ ____________

Leave with Pay Leave without Pay

FOR HR USE: [ ] [ ]
Credits Availed Balance
SL / VL __________ _________ _________
SL / VL __________ _________ _________

HR 2016 Form No. HR/F-024