Employee Name:HR ID:

Department: Division PlatformDepartment Manager:

________________________________________________________________________

PLEASE SUBMIT THE APPROVED LEAVE APPLICATION TO HR (original copy)

ANNUAL VACATIONPLEASE CHECK THE APPROPRIATE BOX(ONE BOX ONLY)

Employee record update

Current Year Entitlement (a) Days

Last Year Accrual (b) Days

YTD Days Taken (c) Days

Balance to Go (d) Days

Note: a+b-c=d

SICK/SICKNESS DISABILITY LEAVE Pls. Attach Doctor’s certificate &

Doctor’s Diagnoses Book

MARRIAGE LEAVE

MATERNITY/FRATERNITY Pls. Attach doctor’s certificate

COMPASSIONATE LEAVE

UNPAID LEAVE

NURSING LEAVE

Remarks

OTHER TIME OFF WITHOUT PAY:Pls. Specify Reason:

________________________________________________________________________

DURATION:

Total:____________________________________________________________________

EMPLOYEE SIGNATURE : Rachel HuangDATE:

DEPARTMENT MANAGER SIGNATUREDATE

HUMAN RESOURCES USE ONLY:

Days actually taken this time_________________(if applicable)

Payroll action taken (if applicable)