LEAVE OF ABSENCE FORM (LOA) Instructions: Complete ALL fields and send via email to your HR Team. EMPLOYEE INFORMATION Employee Name Employee no. ABSENCE TYPE DURATION OF LEAVE Start of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY End of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY Employee Status APPROVALS HR Contact Name Employee Number Signature Date Country
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LEAVE OF ABSENCE FORM (LOA)
Instructions: Complete ALL fields and send via email to your HR Team.
EMPLOYEE INFORMATION
Employee Name Employee no.
ABSENCE TYPE
DURATION OF LEAVE
Start of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY
End of Leave _ _ / _ _ / _ _ _ _ DD/MM/YYYY
Employee Status
APPROVALS
HR Contact
Name
Employee Number
Signature
Date
Country
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