LegalDocs

Request for Leave Extension - Template, Sample Form Pro · NG-law

✓ Valid in Nigeria · drafted to comply with local law

Create your Request for Leave Extension - Template, Sample Form for use in Nigeria. Answer a few plain-English questions and the document fills in automatically as you go — then download it in Word and PDF, ready to sign or share. This version has been professionally rewritten to comply with local law.

  • Answer 27 simple questions — the document fills in as you go
  • Live preview: watch your document update in real time
  • Download as Word (.docx) and PDF
  • Edit your answers and re-download anytime
Save to access it later, on any device.

Fill in the details

0/27

Type below — the document on the right updates as you go.

Request for Leave Extension - Template, Sample Form
🔒The clauses below are blurred in the preview. Fill in your details, then pay once to unlock the full document and download it as Word & PDF.

________
________
Phone: ________
Email: ________
Staff/Employee No.: ________


Date: ________

The ________
________
________

Dear Sir/Madam,

RE: APPLICATION FOR EXTENSION OF SICK LEAVE

1.  I, ________, currently employed by ________ in the position of ________ within the ________ department, respectfully write to formally request an extension of my approved sick leave.

2.  I had earlier applied for and was granted sick leave on account of the following medical condition:

________

3.  The leave previously granted to me was for a period of ________, commencing on ________ and ending on ________, with my expected date of resumption being ________.

4.  Regrettably, I am unable to resume my duties on the scheduled date for the following reasons:

________

5.  In view of the foregoing, I hereby respectfully apply for an extension of my sick leave for a further period of ________, commencing on ________ and ending on ________, after which I expect to resume my duties on ________.

7.  Particulars of the certifying medical practitioner are as follows:

Name of Medical Practitioner: ________
Hospital/Clinic: ________
Address: ________
Date of Medical Certificate: ________

8.  I confirm that this extension is necessary solely for the purpose of my recovery, and I give my undertaking to resume work and continue the discharge of my duties promptly upon being certified fit and restored to good health.

9.  I sincerely apologise for any inconvenience this may cause to the Company and assure you of my continued commitment to my responsibilities. Should you require any further information or clarification, I remain available on the telephone number ________ and at the email address ________.

I thank you for your understanding and kind consideration of this application, and I look forward to your favourable response.


Yours faithfully,




__________________________
________
(Applicant/Employee)
Signature: ________
Date: ________

Fields you complete are inserted into the document live. This template is general guidance only — not legal advice.