Transcription of ANNEXURE B-APPLICATION TIL Long v1
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ANNEXURE B-APPLICATION TIL Long v1
CONFIDENTIAL APPLICATION FORM TEMPORARY incapacity leave LONG PERIOD CONFIDENTIAL 1 ANNEXURE B APPLICATON FORM TEMPORARY incapacity leave LONG PERIOD IMPORTANT 1 This application form must be completed in respect of incapacity leave periods of 30 working days or more. 2 This form comprises six parts, Parts A to F. The employee must complete Parts A and B. The employee s attending doctor must complete Part C. It is the employee s responsibility to have the said part completed by the doctor. Parts D to F are for official use. 3 Please ensure that this form is duly completed, signed and accompanied by all the required supporting documents, as missing or omitted information will delay finalisation of the application.
confidential application form temporary incapacity leave long period confidential 2 part a: employee’s application for temporary incapacity leave
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