“
Uniting for Local Autonomy,
Converging National and
Local Growth
” 28F Unit 2803 Summit One Tower 530 Shaw Boulevard, Mandaluyong City
Telephone: (+632) 8534-6787 Telefax: (+632) 8534-6789 E-Mail: [email protected], [email protected]
Website: www.ulap.net.ph Facebook: www.facebook.com/ulap.net.ph
LEAVE APPLICATION FORM NO NO. 2024-___
Date : ________________________
Employee’s Name : ________________________________________________________________
To be filled out by the Director for Finance and Administration
TOTAL Leave Owing: _______________________
NOTE:
Available Leave Owing: _____________________ Owing refers to all leaves credited to an employee.
To be filled out by the Employee
Leave Type : (Check one) Vacation Leave Sick Leave LOA Other
Reason for leave :
__________________________________________________________________________________________________
Leave From Date : Leave to Date :
Number of Days Taken : Days Paid : Days Unpaid:
Signature of the ______________________________________________
Employee:
Comment :
Approved by: Noted by:
Executive Director Director for Finance and Administration
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