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LEAVE REQUEST FORM
[coniTACT oeraits/WhICE ON TEAVE:
Home Address:
Home Country Number:
Employee No: Department:
Leave Start Date: Leave End Date:
No of Days:
Last day at Work: Date of Resuming:
Name of Substitute:
Signature of Substitute Date:
Request advance salary payment? [J Yes. [No (Available only if employee is on
leave during a Payroll Periad)
{s this @ revised Leave Request? Oves Oo
‘TYPE OF LEAVE
1 Annual 1D unpaid CO study teave =) Hal) OD Maternity
Gi sick Ci compassionate [J examteave J] ilness during Leave
1 Late Return from Leave
1 Number and Type of tickets enttied to. (tf Applicable)
Air Port Destination:
Employee Signature Date
Immediate Superior Approval aa
(PLEASE PRINT NAME AND SIGN}
‘Second Line Managers Approvel ae
{PLEASE PRINTHAME & SIGN)
Leave Days Available Leave Balance:
Verified by HR Date
‘Approved by GM ous