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Employee Name
Employee Address (Include City, State and Zip Code)
Employee Personal Phone Number

Date

Authority Name
Authority Designation/Title
Name of Organization
Organization Address (Include City, State and Zip Code)

Subject: Request for Leave

Dear Ma'am/Sir/Mr./Ms. Last Name,

I request a leave of absence for a period of (number of days/weeks) from (mention dates). The reason is that (give reason in short - medical or personal).

I may have to travel out of the city during this period. However, I am accessible through cell phone (cell phone number here) and e-mail (personal e-mail address here) if there are any questions regarding work. I have also requested (give name of colleague who will be responsible in your absence) to overlook any work that may need to be done in my absence.

Your response is requested as soon as possible. Thank you for your consideration.

Sincerely,

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