Leave Application

"*" indicates required fields

Serial No

Date of Request*

Full Name*

Designation*

Employee ID*

Purpose Of Leave*

Total No Of Days*

Leave Start Date*

Leave End Date*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Ticket Required*

Onward Date

Return Date

Onward Journey From

Return Journey From

Employee Acknowledgment

The employee irrevocably and unequivocally acknowledges that his late return to work will result in a colossal disruption and turbulence to the operations of the employer.
The employee irrevocably and unequivocally acknowledges that his late return to work will result in colossal material and reputational losses to the employer.
The employee irrevocably and unequivocally acknowledges that his late return to work shall be considered as a deliberate abstention from performing his main duties, contrary to his employment contract.
All other conditions and events are subject to the rules of Decree Law (33/2021) concerning the regulation of work relations.

I agree to the terms and conditions stated above

Employee Signature

Date

Leave & Air Ticket Entitlement
Annual Leave Entitlement (days):		Availed Till Date:		Balance Available:		Joining Date:
Air Ticket Entitlement (days):		Availed Till Date:		Balance Available:		Notes:

Remarks

Reporting Manager / HOD*

HEAD - Human Resource & Administration*

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