Form No.

PL:6(OM)

Address while on Leave

60009

SUDIPTA KUMAR GIRI

LEAVE APPLICATION
C/o Village Pin Code

Empl . Code Dept./Sec.Code

DESIGN Dept./Sec. Name

Name Designation

1620, MADURDAHA

DY. MANAGER
ASWINI KR. GIRI

Steel Plantech Engg. India Pvt. Ltd. KOLKATA - 700 156

Father's / Husband's Name FOR URGENT WORK Reason of Leave Leave applied for

700 107

Nature (Leave) Casual Sick Privilege

Days

Form date

To date

Leave due

Leave granted W / Pay W /o Pay

Telegraph Office

20.11.13 28.11.13
Date Recommended / rejected due to Sig./T.I. of Application Sanctioned/Reected due to

Date

Time Keeper

Est. Asst.

Date

Section I/C

Date

Head of Deptt.

Sig./T.I. of Applicant

Name: SUDIPTA KUMAR GIRI Designation: DY. MANAGER Empl Code: 60009 Dept / Quarry Code: DESIGN has been granted / not granted leave for TWO days from 20.11.13 & 28.11.13 with pay / without pay. He must report for duty on.at.....A.M. / P.M. failing which disciplinary action may be taken. Leave refused due to....... LEAVE ORDER NO. Name Empl. Code Date. Designation Dept. Sec. Name Dept. Sec. Code

Form No. PL:6(OM)

LEAVE APPLICATION
Address while on Leave Leave granted W / Pay W /o Pay Section I/C C/o Village Pin Code

Empl . Code

Name Designation Father's / Husband's Name

Steel Plantech Engg. India Pvt. Ltd. KOLKATA - 700 156

Dept./Sec.Code Dept./Sec. Name

Reason of Leave Leave applied for Nature (Leave) Casual Sick Privilege Days Form date To date

Telegraph Office

Leave due

Date Recommended / rejected due to

Sig./T.I. of Application Sanctioned/Reected due to

Date

Time Keeper

Est. Asst.

Date

Date

Head of Deptt.

Sig./T.I. of Applicant

Name........Designation....Empl Code..Dept / Quarry Code.... has been granted / not granted leave for ........days from...to.with pay / without pay. He must report for duty on.at.....A.M. / P.M. failing which disciplinary action may be taken. Leave refused due to....... LEAVE ORDER NO. Name Empl. Code Date. Designation Dept. Sec. Name Dept. Sec. Code

, MADURDAHA
Post Office Dist.

24 Pgs. South West Bengal

State

Leave recommended for ...days

Date

Medical Officer Leave order reveived

Head of Deptt.

Sig./T.I. of Applicant

y Code: DESIGN

disciplinary action may be taken.

Head of Dept./Manager Received your leave applicaiton Dated________________ Date ________ T.K. / Est. Asst.

Post Office Dist.

State
Leave recommended for ...days

Date

Medical Officer Leave order reveived

Head of Deptt.

Sig./T.I. of Applicant

Dept / Quarry Code.... .with pay / without pay. disciplinary action may be taken.

Head of Dept./Manager Received your leave applicaiton Dated________________ Date ________ T.K. / Est. Asst.