Request for Leave of Absence

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{company_phone_number}}

Email: {{company_email}}

Website: {{company_website}}

Date

{{date}}

Employee Information

Employee Name: {{employee_name}}

Employee ID: {{employee_id}}

Department: {{department}}

Position: {{position}}

To

{{manager_name}}

{{manager_title}}

Subject

Request for Leave of Absence

Leave Details

I am writing to formally request a leave of absence from my position as {{position}}.

Type of Leave: {{leave_type}} (e.g., Annual Leave, Unpaid Leave, Sick Leave, Parental Leave, Special Leave)

Requested Start Date: {{start_date}}

Requested End Date: {{end_date}}

Total Number of Days: {{number_of_days}}

Reason for Leave (Optional, but may be required for certain leave types): {{reason_for_leave}}

Coverage during Absence

During my absence, I can be contacted at {{contact_phone_number}} or {{contact_email}}. I will ensure all urgent tasks are handed over to {{colleague_name}} ({{colleague_position}}) prior to my departure.

Declaration

I understand that this request is subject to approval based on company policy and operational requirements. I also understand that unauthorized extended leave may result in disciplinary action.

Approval (For Management Use Only)

This leave request is: [ ] Approved / [ ] Denied

Approved Start Date: {{approved_start_date}}

Approved End Date: {{approved_end_date}}

Comments: {{approval_comments}}

Manager's Name: ________________________

Manager's Signature: ______________________

Date: ________________________

Signature

Sincerely,

________________________

{{employee_name}}

Date: {{signature_date}}