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UPDATED LEAVE FORM 2024

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joylandcyber2004
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57 views2 pages

UPDATED LEAVE FORM 2024

Uploaded by

joylandcyber2004
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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DEPARTMENT OF HEALTH

REF.NO. _____________________ DATE: __________________

RE: ANNUAL LEAVE FORM


PART I: TO BE FILLED BY THE APPLICANT
I……………………………………………………………..
P/NO………………………………………………………
Designation…………………………………… Job group……………
Station…………………………………
Wish to apply for…………days leave with effect from…………………………. to
…………………………….
My leave address will be as follows:
P.O. Box ………………………………Cell No: ..........................Applicant’s Signature
…………………

PART II: TO BE COMPLETED BY PERSONNEL SECTION


The officer is entitled to …………………….…days annual leave for
year…………………………………
Total Leave Due ………………………………days
Leave now applied for ………………………….….days
Leave Balance Due ………………………………days for the
year…………………………………………

Name………………………………………………………………………….
Signature…………………………………….

PART III: TO BE COMPLETED BY IMMEDIATE SUPERVISOR/ HEAD OF


DEPARTMENT
Approval is granted for the officer to proceed on…………… days annual leave with
effect
from…………………………..to …………………… and resume duties on
……………………………

In the absence of the officer his/her duties will be performed


by…………………………………………..
Name …………………………………………………………Designation…………………….
……………..……………
Sign………………………………………………………….

PART IV: TO BE COUNTERSIGNED BY CDH/MED.SUP/CHAO

Name …………………………………………………………Designation…………………….
……………..……………
Sign………………………………………………………….

CC: HUMAN RESOURCE - HEALTH

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