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Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

ABSENCE REQUEST FORM

Date: {{date}}

Employee Name: {{employee_name}}

Employee ID: {{employee_id}}

Department: {{department}}

Type of Absence

Please tick the appropriate box:

[ ] Annual Leave

[ ] Sick Leave (Attach medical certificate if applicable)

[ ] Compassionate Leave

[ ] Maternity/Paternity Leave

[ ] Unpaid Leave

[ ] Other (Specify): {{other_absence_type}}

Absence Details

Start Date of Absence: {{start_date}}

End Date of Absence: {{end_date}}

Total Number of Days/Hours Requested: {{total_days_hours}}

Reason for Absence: {{reason_for_absence}}

Employee Declaration

I hereby request the above-mentioned absence and confirm that the information provided is accurate and complete. I understand that this request is subject to approval by my manager and the HR department, and that approval will be based on company policy, operational requirements, and my leave balance.

Employee Signature: _________________________ Date: {{declaration_date}}

Manager Approval

Manager's Name: {{manager_name}}

Status:

[ ] Approved

[ ] Denied (Reason: {{denial_reason}})

Comments: {{manager_comments}}

Manager's Signature: _________________________ Date: {{manager_approval_date}}

HR Department Use Only

Leave Balance Checked by HR: [ ] Yes [ ] No

Remaining Annual Leave Days: {{remaining_annual_leave}}

Remaining Sick Leave Days: {{remaining_sick_leave}}

HR Representative Name: {{hr_representative_name}}

HR Representative Signature: _________________________ Date: {{hr_approval_date}}

Important Notes

- All absence requests must be submitted at least {{notice_period}} working days in advance for annual leave, unless in emergencies.

- For sick leave exceeding {{sick_leave_days_threshold}} consecutive days, a medical certificate is mandatory.

- Unpaid leave requests will be considered on a case-by-case basis and require special approval.

- Employees are responsible for ensuring that their work is covered during their absence.

Signature Block

_________________________

{{company_name}}

{{date}}