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Leave Form

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LEAVE APPLICATION FORM

Employee Name: MORSHED BIN ANSARI. Employee ID: 20140321

Company Name: NILOY MOTORS


Department: SPD Location: BOROBARI
LTD WAREHOUSE
Date of Application: 27.03.2019 Date of Leave: 20/03/19
Total Leave: 01
Reason: Medical leave. (DD / MM / YY) (DD / MM / YY)

Employment status of the Applicant: Contact information during leave period:


 Confirmed  On probation (Mandatory)

Nature of Leave (Please tick the appropriate box) Name: Morshed Bin Ansari

Personal Earned Extraordinary Address: Shewrapara,Dhaka


Casual
Wedding Maternity
Personal Phone/Mobile: 01919098478
Family Death in
Medical Hospitalization of Email address:
Vacation Family
Family

Recommendation as applicable: Supervisor/ CMO/CBO/


Dept. Head /Director Employee’s Signature with Date

To be Approved by Manager/CBO / Director / Advisor / ED / MD / Vice Chairperson / Chairman

Name of the Supervisor: Md. Rashedul Islam-20180701

(Supervisors are requested to ensure sufficient leave is available before approving it.)
Leave Recommended (Please tick the appropriate box):  With pay  Without pay

Number of Casual Earned Medical Death in Extraordinary Family


days leave vacation
enjoyed
Family
previously: days 01 days
…………days …………days …………days …………days

Supervisor’s Comments (If any)


……………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………..

Date: ………………………………….. Signature: ………………………………

To be Approved by Director Human Resource (As Applicable)

Leave sanctioned (please tick the appropriate box):  With pay  Without pay

Remarks: ……………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………

Date: ……………………………….. Signature…………………………………….


Applicants Copy
Date of Leave: …………………………………………………….. Signature: ……………………………………………………………………….

Date of Received: …………………………………………. Employee ID: …………………………………

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