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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Form X - Leave Application Form

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Name of applicant : ___________________________________________

Application for :

  • Annual leave
  • Special leave
  • Sick leave
  • Maternity leave

Period of leave required from ______________________________ (first day of leave) for ______ days and shall return to work on ___________________

Address during leave:

____________________________________________________________

____________________________________________________________

Contact number : ___________________________________________

Conditions regarding remuneration :

____________________________________________________________

____________________________________________________________

________________________
Employee's signature

________________________
Date


Approved : Yes / No

If disapproved, reasons :

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________
Employer's signature

Compiled by M. Scheepers

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