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Leave Application Form

This document is a leave application form for an employee named Alankar Bhaskar Borkar. It includes sections for the employee to provide information about the requested leave such as purpose and contact details. It also includes undertakings from a substitute employee confirming they can take over responsibilities, as well as from the applicant confirming their return plans. The form is to be filled out and signed by the applicant, substitute, HR manager, unit manager and personnel department to process the leave application.

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Arun Kumar Shakar
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690 views4 pages

Leave Application Form

This document is a leave application form for an employee named Alankar Bhaskar Borkar. It includes sections for the employee to provide information about the requested leave such as purpose and contact details. It also includes undertakings from a substitute employee confirming they can take over responsibilities, as well as from the applicant confirming their return plans. The form is to be filled out and signed by the applicant, substitute, HR manager, unit manager and personnel department to process the leave application.

Uploaded by

Arun Kumar Shakar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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LEAVE APPLICATION FORM

TO BE FILLED BY THE EMPLOYEE DATE :

NAME: CO. / UNIT :

DESIGNATION: DEPARTMENT :

LEAVE REQUIRED

PURPOSE OF LEAVE

ADDRESS & TEL NO.


WHILE ON LEAVE

UNDERTAKING OF SUBSTITUTE
I, Ronak Purohit CONFIRM THAT I AM FULLY CONVERSANT WITH THE RESPONSIBILITIES OF MR. / MS. Alankar Bhaskar Borkar AND

UNDERTAKE TO TAKE OVER THE SAME IN HIS / HER ABSENCE AND CARRY OUT THE SAME ALONG WITH MY PRESENT WORK.

________________
SUBSTITUTE

________________
APPLICANT HR MANAGER MANAGER

UNDERTAKING OF THE APPLICANT

I CONFIRM THAT THE RESERVATION FOR THE RETURN JOURNEY HAS BEEN DONE AND UNDERTAKE TO RESUME DUTY ON 20.01.2018
FAILING WHICH THE MANAGEMENT MAY TERMINATE MY SERVICES AND I WILL FORFEIT ALL CLAIMS FOR GRATUITY AND OTHER
SERVICE TERMINATION BENEFITS.

I HAVE NOMINATED MR. Ronak Purohit_AS MY SUBSTITUTE AND CONFIRM THAT HE / SHE HAS COMPLETE KNOWLEDDGE OF MY JOB
AND WILL CARRY OUT THE SAME AS PER PROCEDURES & SYSTEMS OF THE COMPANY.

I CONFIRM THAT I HAVE HANDED OVER THE COMPANY PROVIDED LAPTOP TO THE UNIT MANAGER.
I AM CARRYING IT FOR OFFICIAL WORK WITH ME. IF YES - UNIT MANAGER APPROVAL ____________________________

ON RESUMING DUTY, I WILL FIRST DEPOSIT MY PASSPORT WITH THE PERSONNEL DEPT. AND COMPLETE FORMALITIES OF
RESUMPTION OF DUTY AND THEN REPORT TO THE UNIT MANAGER. I FULLY UNDERSTAND AND AGREE THAT I WILL NOT BE ENTITLED
TO SALARY IF ABOVE PROCEDURE IS NOT FOLLOWED & COMPLETED.

________________________
SIGNATURE OF APPLICANT
BBG / LAF 1
TO BE FILLED BY PERSONNEL DEPARTMENT

NAME UNIT LEAVE REF. NO.

DATE OF JOINING ELIGIBILITY ANNUAL / BI - ANNUAL

LAST PAID LEAVE FROM TO BASIC DHS.___________P.M.


HRA DHS.___________P.M.
LEAVE NOW APPLIED FROM TO ALLOWANCE DHS.___________P.M.

LEAVE WITHOUT PAY ENJOYED SINCE LAST PAID LEAVE :


1. DELAY IN RETURN FROM LAST PAID LEAVE FROM : TO DAYS
2. OTHER LEAVE WITHOUT PAY FROM : TO DAYS
FROM : TO DAYS
TOTAL DAYS :

PASSAGE ELIGIBILITY : (1) SELF / SELF + WIFE / FAMILY (2) FROM DUBAI TO : _______________
REMARKS (IF ANY)

TO BE FILLED BY THE CO. / UNIT ACCOUNTS DEPARTMENT :

SALARY : FROM __________ TO __________ DAYS DHS.


LEAVE SALARY :
For the Period From ___________ To __________ DAYS
Less Proportionate for leave w/o pay DAYS
NET LEAVE: DAYS

To be paid as:
Days @ p.m. Dhs.
Days @ p.m. Dhs.
DHS.
H. R. A. : FROM _________ TO _________ DAYS______ @ DHS. P.M. DHS.
OTHERS : DHS.

FARE : SELF : Dhs.


WIFE : Dhs.
CHILDREN: NOS. FULL TICKETS Dhs.
CHILDREN: NOS. FULL TICKETS Dhs.
DHS.
LESS DEDUCTIONS FOR:
Loan Dhs.
Advance for expenses Dhs.
Others Dhs. DHS.

NET PAYABLE TO EMPLOYEE / BANK DHS.

FINANCE MANAGER
REMARKS :
MR. A. B. BHATIA

BBG / LAF 2

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