Leave Application Form
Employee Information:
Employee Name: _________________________
Employee ID: _________________________
Department: _________________________
Job Title: _________________________
Contact Number: _________________________
Email Address: _________________________
Leave Details:
Type of Leave (e.g., Annual Leave, Sick Leave, Personal Leave, etc.):
_________________________
Start Date: _________________________
End Date: _________________________
Total Number of Days Requested: _________________________
Reason for Leave (Please provide a brief explanation. For medical leave, a doctor's
certificate may be required): _________________________
_________________________ _________________________
Handover Information (if applicable):
Tasks to be Completed Before Leave: _________________________
_________________________ _________________________
Person Handing Over Tasks To: _________________________
Contact Information of Handover Person: _________________________
Employee Declaration:
I hereby request the above-mentioned leave and confirm that the information provided is
accurate and true.
Employee Signature: _________________________ Date: _________________________
Supervisor/Manager Approval:
Supervisor/Manager Name: _________________________
Supervisor/Manager Title: _________________________
Approval Status (Approved/Denied): _________________________
Comments/Reasons (if applicable): _________________________
_________________________ _________________________
Supervisor/Manager Signature: _________________________ Date: ______________________