LEAVE APPLICATION FORM
Employee’s Name: _____________________________________ Employee Code:
Designation: __________________________________________ Date of Joining: _________________
Department / Office: School / Institute:
Leave Type: FULL HALF SHORT
From: To: ___________ No. of Days (s) / Hours (s): ______ _
Leave Category:
Casual /Sick* Earned Maternity Any Other _____________________
Reason:
Applicant’s Signature: ___________________ Date:
Officiating Officer’s Name:
Officiating Officer’s Signature: ________________________ Date:___________________
RECOMMENDATION
CoD / Immediate In-Charge: ________________________________ Date: __________________
Dean / Director/ Head of Support Office: _____________________ Date: __________________
FOR OFFICE USE ONLY
Received By: _________________________ Date: ___________________
Leave Record | Casual / Sick | Earned |
Previous Balance | ||
On This Form | ||
Current Balance |
Head OHR: _________________________ Date: _____________________
Rector: __________________________ Date: _____________________
Remarks: ___________________________________________________________________________
*In Case of Sick Leave for more than three days, a valid medical certificate must be attached.
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