☐

LEAVE AND UNDERTIME

APPLICATION FORM
Name: Department: Date of Filing:

Type of Leave
☐Sick Leave ☐Under
Under time
time ☐Maternity Leave
☐Vacation Leave ☐ Half
Half Day
Day ☐Others:
☐Emergency Leave ☐
Paternity Leave
Paternity Leave
Total number of Days Inclusive Date/s
From To

Reason:

Note: Employee must attach Medical Certificate if SL is Three (3) days or more.
Requested by: Approved by: Received by and date received:

HRD
Employee Immediate Superior
FOR HRD USE ONLY
SL VL EL ML PL
Current Leave Balance to Date
Less Leave Application
Leave Balance
Distribution: Copy 1 – Employee Copy 2 – HRD HR Form 001 Revised Series of 2012
☐

LEAVE AND UNDERTIME

APPLICATION FORM
Name: Department: Date of Filing:

Type of Leave
☐Sick Leave ☐Under
Under time
time ☐Maternity Leave
☐Vacation Leave ☐ Half
Half Day
Day ☐Others:
☐Emergency Leave ☐
Paternity Leave
Paternity Leave
Total number of Days Inclusive Date/s
From To

Reason:

Note: Employee must attach Medical Certificate if SL is Three (3) days or more.
Requested by: Approved by: Received by and date received:

HRD
Employee Immediate Superior
FOR HRD USE ONLY
SL VL EL ML PL
Current Leave Balance to Date
Less Leave Application
Leave Balance
Distribution: Copy 1 – Employee Copy 2 – HRD HR Form 001 Revised Series of 2012