[LTR]LEAVE APPLICATION FORM

EC No. : NAME : DESIGNATION :
FUNCTION REPORTING MANAGER (Sanctioning Authority) LOCATION
TYPE OF LEAVE PERIOD TOTAL DAYS ON LEAVE LEAVES AVAILABLE LEAVES DUE
C.L M.C.L.
FROM TO
M.L Comp Off ADDRESS WHILE ON LEAVE/CONTACT TELEPHONE NO. PERSON RESPONSIBLE IN ABSENCE
REASON For LEAVE


____________________ ___________________ ____________
HR Department Recommended by Sanctioned by

UNDERTAKING

I undertake that if I overstay on expiry of the sanctioned leave, I shall be marked as absent in my attendance register and if I want to extend my leave, I shall intimate to HR department in due time and in the event of my illness, I shall submit Medical Certificate from the appropriate Medical authority.
Signature of Applicant
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