Time Off Request Form

Employee Details

Type of Leave Requested

Annual Leave
Sick Leave
Personal Leave
Compassionate Leave
Parental Leave
Unpaid Leave
Study Leave
Other (specify below)

Leave Period

Current Leave Balance (to be completed by HR)
___
Annual Leave Remaining
___
After This Request
___
Days Used This Year

Reason / Comments

I confirm that I have arranged cover for my responsibilities during my absence where required.

Approval

Employee Signature

Signature

Date

Manager Approval

Signature

Date

Decision
APPROVED
DECLINED