DPSA Application for Leave of Absence
DPSA Application for Leave of Absence – Z1(a) – Application for leave of absence
Complete the form using Adobe Acrobat Reader and print.
d mmmm yyyy = 1 January 2013 for example
typing “1 01 2013” will result in “1 January 2013”
HH:MM = 13:30
typing “13:30” will result in “13:30”
See Also: How To Prepare for DPSA interview
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Z1 (a) APPLICATION FOR LEAVE OF ABSENCE
I hereby certify that I have acquainted myself of my available leave credits and with the rules governing the leave I have applied for. Further, I am certifying that the information provided is correct. Any falsification of information in this regard may form ground for disciplinary action. Furthermore, I fully understand that if I do not have sufficient leave credits from my previous or current leave cycle to cover for my application, my capped leave as at 30 June 2000 will be automatically utilised.
REMARKS (If not recommended please state the reasons & the dates in the case of rescheduling):
REMARKS (If approved with a change in condition of payment or not approved, please provide motivation):
1. Applications in respect of sick leave of three or more days must be accompanied by a medical certificate issued by a registered medical practitioner.
2. Applications for adoption leaves must be accompanied by a declaration on how the entitlement will be used in the case where both spouses are in the employ of the Public Service.
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