Name of company
LEAVE APPLICATION FORM
To
The General Manager,
……………………..
…………………
Date ……….. Sir,
Sub: Application for Leave
Name Department HR & Admin
Type of leave: Casual /Sick / Earned Leave / Compensatory
Pay Code …P1692………………..Card No……3421………………………………………………………
Leave Schedule
From ……………………….to ……………………….
From ……………………….to ……………………….
From ……………………….to ……………………….
From ……………………….to ……………………….
From ……………………….to ……………………….
From ……………………….to ……………………….
Total No. of leave Day Contact Number ………………………………….
Reason: ……………………………………………………………………………………
Address during leave …………………………………………………
(Application Signature) (Recommended By) (Approved By)
Further I understand that the leave applied is subject to the sanction of Employer and Otherwise, it
can be treated as an absent .Also I confirm that if I overstay over and above the Sanctioned period
without proper information to you I will automatically loose the lien on My job. Totally on my
responsibility.
Yours faithfully
(Signature of Employee)
To be field in officer
Leave Entitlement Leave availed Balance
EL 10 Nill 10 Days
CL 07 1 Day 6 Days
SL 07 1 Day 6 Days
Signature