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Cleanstation Security Inspections Leave of Absence Form
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Applicant Name:
Date of Filing:
Organization:
Purpose for Leave:
Dates of Leave:
Number of Days:
Inclusive Days:
Type of Leave
Annual Leave
Sick Leave
Maternity Leave
Other:
Additional Remarks:
To Be Filled Out by Management
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Reason for disapproval:
Supervisor Signature
Date
Message
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