APPLICATION FOR LEAVE

TYPE OF LEAVE Annual Leave Long Service Leave Aust Defence Force Leave Study Leave Jury Duty Time in Lieu (PEL employees
only)

SES Leave Alternative Holiday (PEL

employees only)

Sick Leave (Form only required for Sick Leave in Big Ws Monarto DC, DSE and PEL Support Offices.)
Note: Personal Leave and Compassionate Leave is recorded in Time and Attendance and no form is required.

EMPLOYEE DETAILS EMPLOYEE NAME LOCATION NAME REGION/DIVISION LOCATION NO. OR COST CENTRE
Full-time

POSITION

EMPLOYEE ID NO

EMPLOYMENT TYPE
Part-time Casual

PAY FREQUENCY
Weekly Fortnightly Monthly

DATES OF LEAVE TYPE OF LEAVE TYPE OF LEAVE FIRST WORKING DATE OF LEAVE

LAST WORKING DATE OF LEAVE

TOTAL NO. OF WORKING DAYS ON LEAVE (excluding public holidays)

DATE RETURNING TO WORK

FIRST WORKING DATE OF LEAVE

LAST WORKING DATE OF LEAVE

TOTAL NO. OF WORKING DAYS ON LEAVE (excluding public holidays) ROSTER DETAILS MON TUE WED THURS FRI SAT

DATE RETURNING TO WORK

SUN HOURS

TOTAL %

For full time employees, does the employee work a 20 day month? YES / NO (please circle) LOADINGS - ANNUAL LEAVE ONLY (IF APPLICABLE - REFER TO EBA) Please specify any loadings applicable to the above weekly roster, OR where less than one week is taken, the hours applicable to the part week taken.

HOURS ON WEEK

HOURS OFF WEEK (where applicable) HOURS %

PUBLIC HOLIDAYS Please specify any Public Holidays that fall during the period of leave.

PUBLIC HOLIDAY

AUTHORISATION EMPLOYEES NAME LINE MANAGER'S NAME HR REPRESENTATIVE/MANAGERS NAME (As Required) HR REPRESENTATIVE/MANAGERS SIGNATURE LINE MANAGER'S SIGNATURE DATE AUTHORISED EMPLOYEES SIGNATURE DATE AUTHORISED DATE

ON AUTHORISATION, THIS FORM IS TO BE FORWARDED TO THE PAYROLL OFFICE FOR PROCESSING