[Company Logo][Company Name]
- 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 Head | From | To | Days | Pay 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
- [Responsibility] will be handled by [Colleague Name] with weekly review by [Reporting Manager].
- Approvals and sign-offs in my name will be delegated to [Name] for the leave period.
- Documentation of processes and open items will be completed by [DD/MM/YYYY].
- 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]