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Leave Request Form PDF

This leave request form allows an employee to request annual leave, sick leave, or other leave from their job. The employee must fill in their name, title, ID code, the dates of the requested leave, and the number of days for each type of leave. They also provide the name of who will cover their duties during their absence and emergency contact information. The form then gets approved by the employee's supervisor and hospital director before being processed by human resources to track the employee's remaining leave balances.

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Farhadullah
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4K views1 page

Leave Request Form PDF

This leave request form allows an employee to request annual leave, sick leave, or other leave from their job. The employee must fill in their name, title, ID code, the dates of the requested leave, and the number of days for each type of leave. They also provide the name of who will cover their duties during their absence and emergency contact information. The form then gets approved by the employee's supervisor and hospital director before being processed by human resources to track the employee's remaining leave balances.

Uploaded by

Farhadullah
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

(Leave is officially granted only when the employee received a copy of this form with the approval of his/her
supervisor and the Admin Manager indicated by signature and date. Please request annual leave at least 5 working
days in advance)

Employee’s Name: ________________________ Leave requested from: ________/________/________

Employee’s Title: _________________________ Leave requested to: _________/________/________

ID Code #:____________ Total # of Days Requested: ____________


TYPE OF LEAVE (account for total days requested below):

Annual Leave: ________________


Sick Leave: ________________
Other (Explain): __________________________________________________

Total days:

Employee who will cover during your absence: ___________________________________________

In case of emergency, Address/Telephone number where you can be reached:

____________________________________________________________________________________

Employee’s Signature: _____________________________ Dated: ______________________

DO NOT WRITE BELOW (For HR Use only)

Annual Sick Others

Number of leave days availed: ___________ ____________ _______________

Number of leave days remaining: ___________ ____________ _______________

Prepared/Checked By:

Name: _________________________ Sign: _____________________ Date: _______________________

Note: _________________________________________________________________________________

Supervisor’s Approval/Comments: _______________________________________________________________

Received By HR Department: _______________________________________

Approved By Hospital Director: ‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

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