Absence Form

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Employee Information

Employee Name: {{employee_name}}

Employee ID: {{employee_id}}

Department: {{department}}

Job Title: {{job_title}}

Type of Absence

Please tick one:

[ ] Annual Leave / Vacation

[ ] Sick Leave

[ ] Personal Leave

[ ] Bereavement Leave

[ ] Maternity/Paternity Leave

[ ] Other (please specify): {{other_absence_type}}

Absence Details

Start Date: {{start_date}}

End Date: {{end_date}}

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

Reason for Absence: {{reason_for_absence}}

Emergency Contact Information (During Absence)

Name: {{emergency_contact_name}}

Relationship: {{emergency_contact_relationship}}

Phone Number: {{emergency_contact_phone}}

Employee Declaration

I hereby request the above-mentioned absence and confirm that the information provided is accurate to the best of my knowledge. I understand that this request is subject to approval by management and adherence to the company's absence policy.

Employee Signature: _________________________ Date: {{employee_signature_date}}

Manager/Supervisor Approval

Status of Request:

[ ] Approved

[ ] Denied

[ ] Contingent Approval (conditions: {{contingent_conditions}})

Comments: {{manager_comments}}

Manager/Supervisor Name: {{manager_name}}

Manager/Supervisor Signature: _________________________ Date: {{manager_signature_date}}

HR Department Use Only

Date Processed: {{hr_processed_date}}

Leave Balance Deducted: {{leave_balance_deducted}}

Remarks: {{hr_remarks}}

HR Representative Signature: _________________________

Signature Block

_________________________

{{approving_manager_name}}

{{approving_manager_title}}

Date: {{approval_date}}