POLICE 118
REPUBLIC OF KENYA
KENYA POLICE
APPLICATION FOR LEAVE
(Subordinate Officers Both Civilian And Uniformed)
(I) 1. NO………………… Rank/Grade ……………………..Name …………………………………
2. Section/Police Station…………………………………………………………………………………
3. Number of days applied for. …………………………………… w.e.t ……………………………
4. Date of last return from leave………………………………………………………………….
5. Destination …………………………………………………………………………………………..
Leave Address …………………………………………………………………………….
6. Telephone No........................................................................................................................
7. Nearest Police Station. …………………………………………………………………………
8. Address for leave salary/cheque …………………………………………………….
(If Applicable). ……………………………………………………...
…………………………..
Signature of the applicant.
(II) Recommended/Not Recommended.
…………………………….
Officer in charge
Date ……………………
(III) eligible for……………………………………………………………………………………days
Outward Road Travel Warrant No. ……………………………. from………………. To ……….
Return Road Travel Warrant No ……………………………. from………………. To ………
Outward Railway Warrant No. ………………………… from………………. To ………….
Return Railway Warrant ……………………………. from………………. To ……….
Casualty return No........................................................................................................................
(To be completed after the leave has been approved)
…………………………….
Office Assistant
Date ……………………
……………………………………………………………………………………………………………..
(IV) ………………….. Days leave approved from……………………………. To ………………..
To report back on duty on......………………………………………………………………………………
OCPD/Head Of Dept
Date………………………..
(Delete where not applicable)
………………………………………………………………………………………………………………….
NOTE FOR GUIDENCE
Complete in duplicate. Approved for leave will be signified by returning original of this application to the
man proceeding on leave as his record, duplicate to remain in personal file.
GPK (L)
