Leave / Approved Absence Application Form(Job Level - G to H)
Section 1 : (to be completed by applicant)
Name: Employee No:
Designation: Site / Contract:
Line Manager: Date of Joining:
No. of days leave required: From: To:
Air Ticket (subject to entitlement): OWN ticket
Destination (nearest International Airport in home country) :
Purpose: ✓ Annual Leave Confidentiality Promise:
Maternity / Paternity Leave Due to the potential sensitive nature of the
Bereavement Leave information provided, we commit to sharing
Compassionate Leave this information with the people who need to
Other Leave (please specify below) know for the purposes of administering
this leave.
Certification: I certify that the leave/absence requested is accurate and for the purpose(s) indicated. I understand that I must comply with EMRILL's
procedures for requesting leave/approved absence and provide additional documentation, including medical certification (if required). I understand that
providing inaccurate information may result in disciplinary action being taken. Unauthorised leave extension will result in Termination.
Employee Signature: Date:
Section 2: (to be completed by Site Admin and Manager)
Leave details verified by:
Site Admin name: Signature:
Line Manger's approval:
Approved
Refused (If refused, state reason below. If annual leave refused, initiate action to reschedule)
Remarks:
AFM / Assistant Manager Signature: SFM / HOD Signature:
Date: Date:
Note to Employee: Once authorised, please forward form to HR Department
Section 3: (to be completed by HR Dept.)
Passport Availability: Visa expiration date:
Annual leave balance:
Other leave entitlement (carry forward / days in lieu / discretionary leave):
Remarks:
Approved by HR:
Name and Signature: Date:
EM-HR-F007( Rev 12) Dated: 1st Dec 2018
b Level - G to H)
Confidentiality Promise:
e to the potential sensitive nature of the
rmation provided, we commit to sharing
information with the people who need to
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leave.
hat I must comply with EMRILL's
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t in Termination.
Date: _____________________
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