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

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Staff No.: ________

Date: ________

The ________
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Dear Sir/Madam,

RE: FORMAL APPLICATION FOR SICK LEAVE

§1. I write further to our conversation of ________ to formally apply for sick leave from my employment as ________ with ________ ("the Company"), pursuant to the terms of my contract of employment dated ________ and in accordance with my entitlement to sick leave under Section 16 of the Labour Act, Cap. L1, Laws of the Federation of Nigeria 2004, and the Company's applicable staff handbook or conditions of service.

§2. I regret to inform you that, on account of ill-health, I am presently unable to discharge my official duties. The nature of my indisposition is as follows:

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§3. In accordance with Section 16(1) of the Labour Act, I enclose herewith a medical certificate issued by a registered medical practitioner, ________ of ________, certifying my incapacity for work and recommending a period of rest and recuperation.

§4. I therefore respectfully request your approval for sick leave for a period of ________ day(s), with effect from ________ to ________ (both dates inclusive).

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§6. To ensure the seamless continuation of work during my absence, I have made arrangements to hand over all pending matters to my colleague, ________, who has kindly agreed to attend to such matters until my return.

§7. Should any urgent matter arise during the period of my absence, I may be reached by telephone on ________ or by electronic mail at ________.

Lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat duis aute irure dolor in reprehenderit voluptate velit esse cillum.

I should be most grateful for your favourable consideration and approval of this application, and I thank you for your understanding.

Yours faithfully,

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Enclosure: Medical Certificate dated ________

FOR OFFICIAL USE — APPROVAL

Application approved / not approved (delete as applicable).

Approved leave period: from ________ to ________.

Name: ________
Designation: ________
Signature & Date: ________