Leave Form
Employees Details
First Name:…………………………………………………… Sir Name:………………………..………. Others:………………………………
Position:………………….….………………...…….. Department:……………………………………………..…………
Contact Phone No:………….………………..…...
Leave Type:
Annual Leave Sick Leave Maternity Leave Paternity Leave Unpaid Leave Others
Comments
Person to Stand in for:………..…………………………………………………………….. Signature……………………………………...
Period of Leave Note: DO not include any public holiday or substituted days in the total
Last Day of Work ____/____/______ Return to work date ____/_____/______ No of days off _______
Signature of Employeee:…………………………………… Date:…………………………………..
Approval Of leave (To be completed by Manager/Supervisor)
Approved ____________________________ Not Approved
Reason for Refusal (if Applicable)
Name of Supervisor/Manager………………………...……………………….. Signature:…………………... Date:…………...
HR/Admin
Leave Days Remaining:…………………………...………
HR Officer Name:…………………….……………………...…………….. Signature:…………………………. Date:……………………
Location:Mwatate, Jiranismart Complex www.jiranismart.com Email:info@jiranismart.com Contact:0722810781
P.O.BOX 25-80305