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Free letter template · Word

Extended Leave Request

An extended leave request asks for a long absence, typically several weeks to a few months, for reasons such as caring for a family member, relocation, recovery or personal circumstances. It plans in advance how different leave heads will be combined and how work will be covered.

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[Company Logo][Company Name]

REQUEST FOR EXTENDED LEAVE

Date:
[Date]

To,
[Head of Department]
[Department]
[Company Name]

Through: [Reporting Manager]
Copy: HR Department

Subject: Request for Extended Leave of [Number] Weeks from [DD/MM/YYYY]

Dear Sir / Madam,

I request extended leave from [DD/MM/YYYY] to [DD/MM/YYYY], a period of [Number] weeks, as I need to [care for my Relation during treatment / travel abroad to support my family / manage my family's relocation]. I have already discussed this with [Reporting Manager].

Proposed Leave Mix

Leave HeadFromToDaysPay Status
Earned Leave[DD/MM/YYYY][DD/MM/YYYY][Number]Paid
Casual Leave[DD/MM/YYYY][DD/MM/YYYY][Number]Paid
Leave Without Pay[DD/MM/YYYY][DD/MM/YYYY][Number]Unpaid

I understand that salary will be deducted for the leave-without-pay days, which will fall in [Month(s)]. Please let me know the effect of this period, if any, on group insurance, PF contributions, performance cycle and leave accrual.

Coverage Plan

  1. [Responsibility] will be handled by [Colleague Name] with weekly review by [Reporting Manager].
  2. Approvals and sign-offs in my name will be delegated to [Name] for the leave period.
  3. Documentation of processes and open items will be completed by [DD/MM/YYYY].
  4. I will be available for a brief call [weekly / when necessary] at [Time].

I will confirm my return by email on or before [DD/MM/YYYY] and rejoin on [DD/MM/YYYY]. I am grateful for your consideration.

Yours sincerely,

[Employee Name]
Employee ID: [Employee ID]
[Designation]
Recommended by
[Reporting Manager]
Approved by
[Authorised Signatory]
HR
[HR Name]

What this template includes

  • Reason and total duration up front
  • Mix of leave heads: EL, CL, LWP in sequence
  • Effect on salary month by month
  • Benefits questions during long leave
  • Comprehensive coverage and handover plan
  • Return date and check-in plan

When to use it

  • Absence of a month or more for caregiving or family reasons
  • Overseas travel to support family, such as a child's birth abroad
  • Planned long recovery after a procedure
  • Personal circumstances where a sabbatical policy does not exist

How to customise this template

  1. 1Work out the leave mix using your latest balance statement
  2. 2Give month-wise paid and unpaid days for payroll clarity
  3. 3Propose an interim cover or temporary replacement if your role is critical
  4. 4Use a sabbatical application instead if your company has a sabbatical policy

HR tips

  • Discuss with your manager before submitting the formal request
  • Approvals for long leave usually need HOD or HR head sign-off
  • Ask whether long LWP affects bonus, increment cycle or service continuity
  • Agree in writing how and when you will confirm your return

For HR & hiring managers

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Frequently asked questions

How do I write an application for long leave?+

Explain the reason and total duration, show how your leave balances and leave without pay will cover the period, present a coverage plan and give a firm return date.

Can I take one month of leave from my job?+

It depends on your balance and the company's approval. Long leave is often a mix of earned leave and leave without pay and requires senior approval.

What is the difference between an extended leave request and a leave extension request?+

An extended leave request is made in advance for a long leave. A leave extension request asks to lengthen leave that has already been sanctioned and is often already running.

All 50 leave management →