Revised LEAVE APPLICATION FORM - 2023 (002)

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LEAVE APPLICATION FORM

To : Human Resource Director

Thru : Head of Department ……..……………………………….……………………………………………………………

Thru : General Manager: ………………………………….…………………………………………………………………….

SECTION I: (to be completed by Officer)

Name of Officer:…………………………..…………………………………………….Designation:…………………..…….…………..

Department:…………………………………………………………….……………..… Type of leave:…..………………………………

Leave days applied for:……………………………….From:…………..…………….... To:………………..……………………..……

Leave address…………………………………….……………………………………..Telephone Contact:.…………..………………

Signature of Officer…………………….…………………………………………….. Date:……………………….….…….……………..

SECTION II: (to be completed by Officer)

Proposed Relief Successor:………………………….……………………………. Designation:……………...……………………

SECTION III: (to be completed by the Human Resource Manager)

COMPUTATION OF LEAVE:

Date last resumed duty : ………………………………….……


Leave days due in year : ……………….…....………………..
Less Leave days already taken : …….………..……………………….
Balance Due : ………………………………………..

LEAVE AS COMPUTED ABOVE: RECOMMENDED/NOT RECOMMENED. Give reasons if not recommended


(This application is in accordance with the leave roster)

Computation checked and leave recorded by: (HRM)….……………………………… Date: ………………………………

SECTION IV: (to be completed by the Director Human Resource)

Your application for leave from: …………………………..… to …………………….….. is Approved/Not Approved

(If not approved, reasons must be given)

……………………….………………………… …………………………………………………………………….

Date Director Human Resource

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