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RAJASTHAN STATE INDUSTRIAL DEVELOPMENT

& INVESTMENT CORPORATION LIMITED:


UDYOG BHAWAN: TILAK MARG: JAIPUR - 302005

LEAVE APPLICATION FORM FOR


MEDICAL/P.L./SURRENDER LEAVE.

1. NAME OF APPLICANT : __________________________


2. FATHER/HUSBAND NAME : __________________________
3. POST HELD : __________________________
4. NAME OF UNIT/CELL : __________________________
5. NATURE OF LEAVE : __________________________
6. PERIOD OF LEAVE : __________________________
7. PREFIX/SUFFIX, IF ANY : __________________________
8. REASONS FOR APPLYING : __________________________
LEAVE : __________________________
9. ADDRESS WHILE ON LEAVE : __________________________
__________________________
__________________________

DATED: ____________ SIGNATURE OF THE APPLICANT


NAME __________________________
DESIGNATION__________________
________________________________
_________________________________________________________________________

(TO BE COMPLETED BY THE COMPETENT AUTHORITY)


Leave applied by Mr./Ms._________________________________________ for the
period from _____________________ to ____________________________ Total
Days ____________ are sanctioned subject to leave titled. During the period of
leave Mr./Ms. _____________________ Designation _______________________
look after his/her work.

(COMPETENT AUTHORITY)
_________________________________________________________________________
No.
Dated:
The above is sent to Deputy Manager (HRD) for further action.

CELL INCHARGE
_________________________________________________________________________

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