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Leave Request Form

1) This is a leave request form for an employee to request different types of paid and unpaid leave. 2) It collects information such as the dates and number of days for annual leave, sick leave, special leave without pay, compensatory time off, and training leave. 3) The employee also provides information on who will cover their work during their absence and their accrued annual leave balance.

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mii sama
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998 views1 page

Leave Request Form

1) This is a leave request form for an employee to request different types of paid and unpaid leave. 2) It collects information such as the dates and number of days for annual leave, sick leave, special leave without pay, compensatory time off, and training leave. 3) The employee also provides information on who will cover their work during their absence and their accrued annual leave balance.

Uploaded by

mii sama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Leave Request Form

Dates inclusive
No. of working
From To
days
Annual leave*                  

Sick Leave (certified) **                  

Sick Leave (uncertified) **                  

Special Leave Without Pay*                  

Compensatory Time Off***                  

Training and Learning Leave****                  

Other types of leave* (please specify)                  


(i.e. Family leave, ML, PL, Adoption leave, jury leave, HL, etc.)

I have accrued ___ days annual leave at the end of _____________ . Indicate last completed month.

In My Absence, my work will be covered by ____________________________________.

Date:
Signature of
Staff Member:

Approval by immediate supervisor

Signature: __________________________ Date: __________


Name: __________________________
Org. unit: __________________________

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