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Leave Request Form

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14 views

Leave Request Form

Uploaded by

officeworkseg35
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Ref no. SEG/HR/HR Docs/Forms/Leave form/01.01.

2023/V1

LEAVE REQUEST FORM


REQUEST DATE DD MM YY
NAME: TEAM MEMBER ID:

DESIGNATION: MOBILE:

BRANCH (DHAKA/SYLHET): DEPARTMENT:

TOTAL LEAVE ENTITLEMENT LEAVE BALANCE (BEFORE REQUEST)


ANNUAL LEAVE DAYS ANNUAL LEAVE DAYS

CASUAL LEAVE DAYS CASUAL LEAVE DAYS

SICK LEAVE DAYS SICK LEAVE DAYS

LEAVE INFORMATION
LEAVE REQUESTED FROM DD MM YY TO/ AND DD MM YY
TOTAL NUMBER OF DAYS REQUESTED AL DAYS CL DAYS SL DAYS

REASON

NAME OF THE LEAVE RELIEVER

DESIGNATION OF THE RELIEVER

CONTACT NUMBER OF THE RELIEVER

SIGNATURE OF APPLICANT SIGNATURE OF THE RELIEVER


ADDRESS & EMERGENCY CONTACT NUMBER DURING LEAVE
ADDRESS

EMERGENCY CONTACT

INLINE SUPERVISOR / DEPARTMENT HEAD USE ONLY


LEAVE APPROVAL: YES NO

IF NO THEN PLEASE STATE THE REASON

SUPERVISOR’S SIGNATURE WITH DATE INLINE SUPERVISOR/DEPARTMENT HEAD’S


NAME: SIGNATURE WITH DATE

CEO / TOP MANAGEMENT USE ONLY


LEAVE APPROVAL: YES NO

IF NO THEN PLEASE STATE THE REASON

CEO / TOP MANAGEMENT'S SIGNATURE WITH DATE


NAME:
NAME:
HR COMMENTS / RECOMMENDATIONS/ REMARKS (IF ANY)

SIGNATURE OF RECEIVER WITH DATE, HR


NAME:
For your personal record please keep a photocopy and send the original to HR

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