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EMPLOYEE'S LEAVE FORM

Name of Employee : Ethel Gretchen A. Casalla Date Filed: 6/10/18

Position :Nurse Employee No._________

Clinic/Department :Alorica Northgate


Aventus
TYPE OF LEAVE
Vacation Leave Emergency Leave Solo Parent Leave Others

Sick Leave Maternity Leave Paternity Leave Pls. specify:

Period of Leave Covered: June 13-14, 2018 2 Total No. of Day

Reason[s]: ___________________________________________________________________________________________

TO BE FILLED UP BY HRDO

Total No. of Leave Credits:____________ Available Balance:__________ Days Applied:__________ Days Balanced:_________

Leave with Pay Leave w/o Pay

Approved by: Received by:

Ethel Gretchen A. Casalla __________________________


Employee's Signature Over Printed Name Immediate Supervisor/Department Head HRDD

cc:Employee/HRDO

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