Leave of absence

Special Security Services Ltd

Leave Of Absense form
This form should be completed if:

Leave of absence is applicable where the one (1) day personal leave will not suffice and the purpose does not apply to any of the other available forms.
Name*

First NameMiddle NameLast Name
Cellphone #*

Area CodePhone Number
Home phone #

Area CodePhone Number
Whatsapp #

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical Benefits #
Social Security #
Department/Location *
Number of days applying for
Travelling overseas

YesNo
If yes, intended address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date requested from *

DayMonthYear
Date
Date requested to*

DayMonthYear
Date
Resume work on

DayMonthYear
Date
Purpose of Leave *
Relieving officer(s):
Employee’s Signature

Clear
Date

MonthDayYear
Date
Date

MonthDayYear
DateHourMinutesAM/PM Option
Scheduling Agent Remarks
Date

MonthDayYear
DateHourMinutesAM/PM Option
With payWithout pay
Operations Manager remarks
Operations Manager's signature.

Clear
Date received

MonthDayYear
Date
Approved by Human Resource manager

YesNo
Human Resources Manager remarks
Human Resources Manager Signature

Clear
Date

MonthDayYear
Date
Reviewed by

Office managerGeneral managerManaging director
Remarks
Signature

Clear
Should be Empty:

Special Security Services Ltd