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vlraff1pu Electric Povver

LEAVE APPLICATION FORM

Section 1. Filled bv Emplovee

Employee Name / lD : Manase Karosekali

: Operator PH Department: OpERATION
DateJoined Company : 15-Sep-15
Schedule : 18-23 & 30 Nov20l6
Total working day 6 day/s
Total Public Holiday day /s
Date return to work :

of Leave Requested (please tick)

Annual Leave E ,rl tr circumcision / Baptism of child
Mass Leave ! mployee 's Marriage
e tr Delivering Baby / Miscarriage *
tr Sick Leave ** fl Employee's Children Marriage tr Bereavement of Family*
n Maternity Leave n Otf'", (please explain)
I wedding preparation

*) Emergency Case - could be submitted to company later with evidence.

**) Should submit meedical report to company.
o Contact Address / phone number during leave period :

1. Detail for Annual Leave Day

a. Remain Annual Leave [0*r'o.v/,
b. Calculatedwith mass Leave within 1 (one) year period :' day/s
c. Employee's Rightfully for personal Annual Leave Day : day/s
d. Balance after taken : 4 day/s

. Annual leave with minus of Balance - will be compensated with salary/ advance ***
n < 1 year working service / nonexistent day/s
n Advance annual leave

for with distinctive which attached by contract

APPROVAI

Requested by Reviewed bv Approved bv

Applicant G.A
'N)
4* fl)'9
Manase lapd Kang Heesuck
Date : Nov 2016 Date : Date :
o Employee who apply personal leave, has to be approved by one's superior by fulfilline this form.
o The Level above Manager(Grade lll) should be approved by president.