LEAVE APPLICATION FORM - Biforst Group

1 LEAVE APPLICATION form Name : _____ Date : _____ Position : _____ Department : _____ Employee No : _____ Please approve absence from work for _____ days, from _____ to _____ , inclusive. Reasons for absence _____ I may be contacted at Telephone No : _____ _____ Applicant s Signature Annual LEAVE Compassionate LEAVE Public Holiday Absent Without Pay Maternity Others , please Specify : _____ Note : Please submit this APPLICATION to your Div / Dept Head 7 days in advance.

2 You are not entitled to go on LEAVE until you receive an approved copy of this form . No. of Days No. of Days No. of Days Remarks Available LEAVE Taken LEAVE Balance Approved / Rejected By Approved By Operation Department General Manager / EAM _____ _____ BG/LAF/01/(11/10/2006 LEAVE APPLICATION form Name : _____ Date : _____ Position : _____ Department : _____ Employee No : _____ Please approve absence from work for _____ days, from _____ to _____ , inclusive.)

3 Reasons for absence _____ I may be contacted at Telephone No : _____ _____ Applicant s Signature Annual LEAVE Compassionate LEAVE Public Holiday Absent Without Pay Maternity Others , please Specify : _____ Note : Please submit this APPLICATION to your Div / Dept Head 7 days in advance. You are not entitled to go on LEAVE until you receive an approved copy of this form . No. of Days No. of Days No. of Days Remarks Available LEAVE Taken LEAVE Balance Approved / Rejected By Approved By Operation Department General Manager / EAM _____ _____

4 LEAVE APPLICATION form Name : _____ Date : _____ Position : _____ Department : _____ Employee No : _____ Please approve absence from work for _____ days, from _____ to _____ , inclusive. Reasons for absence _____ I may be contacted at Telephone No : _____ _____ Applicant s Signature Annual LEAVE Compassionate LEAVE Public Holiday Absent Without Pay Maternity Others , please Specify : _____ Note : Please submit this APPLICATION to your Div / Dept Head 7 days in advance.

5 You are not entitled to go on LEAVE until you receive an approved copy of this form . No. of Days No. of Days No. of Days Remarks Available LEAVE Taken LEAVE Balance Approved / Rejected By Approved By Operation Department General Manager / EAM _____ _____