Leave Application Form Example
Example document for Leave Application Form. Use this as a reference when creating your own.
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Document: Leave Application Form
Example Document
Last updated 7/27/2026
LEAVE APPLICATION FORM
Employee Details
| Field | Details |
|---|---|
| Full Name | Jack Smith |
| Employee ID | EMP-045 |
| Job Title | Qualified Electrician |
| Employment Type | [X] Full Time [ ] Part Time [ ] Casual |
| Department/Team | Installation Team A |
| Date of Application | 15/03/2024 |
Leave Details
| Field | Details |
|---|---|
| Type of Leave | [X] Annual Leave [ ] Personal/Carers Leave [ ] Long Service Leave [ ] Unpaid Leave [ ] Other: |
| Start Date | 01/04/2024 |
| End Date | 12/04/2024 |
| Return to Work Date | 15/04/2024 |
| Total Hours/Days Requested | 10 Days (80 Hours) |
| Reason for Leave | Family holiday and travel |
Supporting Documents
[ ] Yes, attached [X] Not applicable
Public Holidays
Do any public holidays fall within this leave period?
[ ] Yes [X] No
Declaration
I certify that the information provided is true and correct. I understand that I must follow company policy regarding notice periods for leave.
Employee Signature: J. Smith
Date: 15/03/2024
Employer / Supervisor Section
| Field | Details |
|---|---|
| Leave Balance at Start Date | [Annual]: 25.5 Days [Personal]: 12 Days |
| Leave Balance after Approval | [Annual]: 15.5 Days [Personal]: 12 Days |
| Decision | [X] Approved [ ] Declined [ ] Approved with Conditions |
| Supervisor Name | Sarah Jones |
| Signature : S. Jones |
Date: 16/03/2024
Comments / Conditions of Approval
Approved. Please ensure the van keys are returned to the office before you leave. Have a safe trip.
Notes
Key Decisions Explained:
- Notice Period: Jack applied on March 15 for leave starting April 1. This gives the employer two weeks notice, which is standard and reasonable for annual leave requests.
- Public Holidays: Jack indicated no public holidays fall during his leave. Since Easter often falls in April, double checking the calendar is important. If a public holiday did occur, it would be paid as a public holiday, not deducted from his annual leave.
- Leave Balance: The supervisor verified the current balance (25.5 days) and calculated the new balance (15.5 days) before signing. This ensures payroll accuracy.
- Handover: The supervisor added a comment about returning the van keys. This is a good practice for trades businesses where assets are assigned to specific employees.
About this Example
Part of the Leave Application Form document collection
Document Type
Leave Application Form
A standard form used by employees to formally request time off from work, ensuring all details are recorded for payroll and compliance.