Doe. Code: FF-HRD- 011 Rev. 1 LEAVE FORM Effective: January 22, 2018 ANNUAL LEAVE SHALL BE FILED AT LEAST TWO (2) WEEKS PRIOR TO THE SCHEDULED DATE. EMPLOYEES NAME Hit. PrlnGlec C. ConilGilhypDATE OF REQUEST _ fyA4 2 Do1y/ DESIGNATION BAC INbeRING Seer nM ity DEPARTMENT OE TYPE OF LEAVE 1 vaceion ET annua OD sexuewe 0 airtaoay Om O su Er veer D woray DATE REQUESTED BEGINS ON: MAY >, 2e1y ENDSON: fy} |, vig TOTAL NO. OF DAYS: aa Cihkepay + Fry, ) REASONS: _Pesfoi) fn MATTERS Zh approved DISAPPROVED PLEASE STATE REASON(S) FOR DISAPPROVAL OF LEAVE: ——MM 220i Noted by: HUMAN RESOURCE MANAGER "VER & ADMIN DEPT PRESIDENT Desin and ConesetbY JONES UNSON ENTERPRISE ARCHITECTURE SOLUTIONS. Except for ho. company logo and information tats owned by DALKIA INCORPORATED, no par of tis document may be reproduced, sored ina reteval ‘system or ransmited in any form or by any means; electronic, mechanical, photocopying, recorcing otherwise, without prior Permission fom the management of the organization.