UNIVERSITY OF HYDERABAD
Application form for Earned Leave / Half pay Leave / Commuted Leave
1. Name of the Employee with Designation :

2. ID No. :
3. Name of the Department/Office and Section :

4. Whether Permanent / Probation / Temporary / Depuration :

5 Nature of leave applied for and number of days with:

/ period __________________, from _________________ to ____________
prefixing ____________ suffixing ____________
6. Purpose for which leave is required :

7. Details of leave last availed :

8. Leave address, if granted :

Date : Signature of the applicant
_______________________________________________________________________________________

Recommended / Not Recommended

Signature & Designation of Officer
_______________________________________________________________________________________

For use in the Office of the Personnel Section
Verified that _____________________ Days ___________________
leave is at credit as on ______________ to him/her.

Sanctioned / Not Sanctioned

Dy. Registrar (P)