LEAVE OF ABSENCE FORM (LOA)

Instructions: Complete ALL fields and send via email to your HR Team.

EMPLOYEE INFORMATION

Employee Name Employee no.

ABSENCE TYPE

DURATION OF LEAVE

Start of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY

End of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY

Employee Status

APPROVALS

HR Contact

Name

Employee Number

Signature

Date

Country