Sample Leave Form
Employees may at times require leave from their jobs. It is recommended that one must fill in a leave form which is normally availed by the HR department in most organizations. The form is also important for documentation purposes. Apart from that, it also helps the hr department to keep records of holidays and leave taken by the employees. Shown below is a sample leave form.
Sample Leave Form
Name of Employee ______________________
Department ____________________________
Social security number ___________________
Date of request __________________________
Category of Leave Requested
Paid leave _____________ Unpaid leave ___________
Other ____ Explain _______________________________________________________
_______________________________________________________________________
Reason for Leave
Vacation/personal leave _____________
Ill Family Member _________________
Employee’s own illness ______________
Care for new child __________________
Other _________ Explain __________________________________________________
_______________________________________________________________________
Start date of leave _____________________________
End date of leave _____________________________
Address during leave __________________________
Phone number during leave _____________________
Special circumstance Explain ______________________________________________
______________________________________________________________________
Employee signature __________________________ Date ________________
Category: HR Forms
