PerformaForChildCareLeave24 11 2015

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

t!

ej-gu a'fet*aa trnfr1{' ffi


fD,tfirs €*dr{
fr I

(alrd-i*rs.Fnrr)
fr-Erf*,
1 . H=|rd li55 ffnfrl{' ttfeFd, tlrrq
2. 4rro ffi firTurrt'rrerc(frfn), tsq
i. *ngsf{trlusArfi tffiaafrl
& rslsr-rzd Av $)tqzt
rfiF
fi+d:_ Rtr-\\_\l-
frfi's dDd'figrgfi *Errstddr/"{folrfqrc-€t gd
gtfFt At{-d
ferr:- ry6 fu'frflrfr f€grdT,
free'{e'ex'rffit
u<rsr:- fw g6ga s riJa ii lslsl-rz frz i.frs (1)/63 fi{s o7-o2-2OL3 w'\ s/st_tzftz
d frs o)/zt o fird re- rz-zor+'

1. oer6r )rrfi6 sitr=trilst' fr? 'rrnr g ffi{t{t #e'A fu E-dfrE Cd fe" €"d*t alro
lfu'd irfr's
frEs,F-go-aars'rqffi reru,rlT a€rfe-ud fisforrrr +ert fu r=*rtrfiot'fug'dr,
€t,,a,ffiqa{grd5+/}1ffo},{nrdr+dB.gdFJa4fdd|€dltdffiaarsodrga?'ft
ut< e' {a.ox'vc& }re'w*tfr i"€art
2. Mrstf,dlrno;g1qdA effilrf,'s'it
dd' Qqsl{ffd
V nn; 4( tnT
6s.6iq6-aa-o-Stra. *s
e. s'fgtfied fffoa{' ;ggT dr 1}.fF1, frfrq

fri6ri-{dt:g{r flrd: aq'\\-\t]


gJ.d' t6 ffifil{' g 5ca
'rr3
Aar ilT+fi frr ehlr Hrer i:

I. a'f**eo rseg rgm ffio't', te's t

*.f .?rd (fi .fF), riilrs I

3.ffi-a-a fu .m d.r{ra' A, thfrq I

4. .rfi .4r'S (ifx1 , fr+r'v i x-no mrr a1fi1ffi7srtfl )iS I

=fr Y-l a r-tf Y- )-1i


e3..rgArrr.o-dnrsis
e. a.'futa-a ft'fi{'rl Psrdr 1fr.fr), tfrq

friz)tr*dt:grs frrd: lg1. \\ \J--


gs.o' t-s ffia+ 6 fcs' ffi ?finr ;r's i:

L. f&fr rdgazffi*rrt' tH,tta'e t


ffifr FdFd/Ufc sq=" EdB fifi{',{r,rifrrst
Y), >) t >) >.'',7
tuCir{E-dd#is
e. ilfut*ed fffcr{r f€Tdr (l.fD, ri-firs
l.
'- '' ry" ffifu* f€g.dr, r|fr's d4fr figr:rfi Tdrfsrrt5fzr,fnrl{rud€ sd s'frFt A}rd fe e'{e'ox'

1. ,?ffrItfq6r/djiHg'rfl6 er 6t rf3
rflirg
2. rg6/s€:fiIsrFlr
3 ditHrtrdd e dfs',{r' d ffi,
dfiurri s a.ry,;r61t fi{S tr€ g}ra
trsn redffia d q"^fr srs 6d
ffr€)
4 rdfil +d'6 gs t'a rye6 6ffi
grEtsar&romE(dTfirs,)
5 FdkF yd f+
ufu, sfr ed e'
6grslrlsrS: ---- fi+d: -----1
gi6
6 fer FB 'r€r ffi sds-J
*€ (flrd---,3 ---- fr
&rrd )tr3
dgccllrrffigdgdsftsa's
fux x.s +d.6 Ee fr f*t spells
ft?ccr-5g1*,Sidtr
8 gd )ffi atd s'SFt iro fre e.
Hlf'( $1r fu6',fg fifS ---3 ----
3d)
9 trEIFJti4tdFf€*ge'drir6.
10 Documentary Evidence in support of
reasons for ccL ( fu{kfl6'd
date
sheet m l*dg fdirde, as the case
may be)
11 r*sft?Hery.sftr'dffi
L2 r*sfdsfrMdffi
13 r-*s fefu q-5 Drfoar'rl-dt' d ffi
t4 )ffi ard/sf gr5'srsf ccl fs.a'
dforii €T u+d e'd r{sq fJ'
fapr.r' it
15 i-fidgFryforr,nrqdeffit,-d
4{fo,inra 3 r=*s Ht +' s.{-
utfr',rs adjust fre Hre T6 3 gfl
tutdrysdffil

tfu*q'a?urstrel
6+r:
?fl:irg':
r*s ffr ? u$ ursnrd Dr3 Frrd F_6nt/€3ttg rErr:
rag)ifre'EH

You might also like