APPLICATION FOR LEAVE OF ABSENCE
Name of Employee Company Department Date Filed
Jerome M. Jalova ALHI CAD August 27, 2020
Leave Type Leave Duration Reason for Leave
x Sick Leave From: August 24, 2020
Vacation Leave To : August 26, 2020 Home Quarantine
Other Leaves: Number of days: 3
Employee Signature
Signature and Approvals: For HR Use Only:
Leave Credits: ( )VL ( )SL ( )ML ( )PL
Approved Disapproved Less this Leave: ________ Balance: __________
Approved with pay Approved without pay
Immediate Superior Noted By
HR Copy