Anticipation of Annual Leave
Applicati
on Form – HR 108 (b)
This form is to be used by employees to apply for Anticipated Annual Leave. You must apply prior to the
Ist April in the current year. Please complete the form in Block Capitals and tick appropriate boxes.
Date Format DDMMYYYY
To be completed by the employee
Surname : First Name:
Grade: Personnel No:
Location: PPS No:
In accordance with the provisions of the HSE Terms and Conditions of Employment (Revised) 2009.I hereby notify
my employer that I wish to apply for permission to take, in the current leave year, annual leave which I will not earn
until the following leave year.
Reason annual leave is applied for:
From date
To date
Signature: Date
To be completed by the Line Manager
I have checked the relevant supporting documentation required for the leave requested.
Application Approved Yes No If no, give reason:
Signature: Date
Name: Grade
Contact Phone No: Mobile No:
Email Address:
To be completed by Human Resources Personnel Administration
System Update by: Name:
Contact Phone No: Date:
Comments:
Circulation List
1 2
3 4
5 6
Explanatory Note: An officer whose annual leave allowance for the current leave year has been exhausted
and who is confronted with an unforeseen but compelling social obligation
e.g. the wedding of a close friend
or relative, may however be allowed to anticipate up to two days of the allowance for the next leave year.
This arrangement will apply only in the last three months of the leave year
The annual leave should only be approved where it is reasonable to expect that the employee will remain
with the HSE to accrue the amount of the leave involved.
HR 1
08 (b)_V2 Apr 2010 Page 1 of 1 Revised 01/04/2010
