Labour Relations Act, 1995 (Act No. 66 of 1995)

Notices

National Bargaining Council for the Road Freight and Logistics Industry (NBCRFLI)

Main Collective Agreement

Schedules

Schedule 6 : Prescribed Forms

Annexure A.8 : Application for Sick Leave Benefit
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A.8

Ver. 06/11

 

 

Annexure A.8

National Bargaining Council for the Road Freight and Logistics Industry

 

APPLICATION FOR SICK LEAVE BENEFIT

 

Private Bag X69, Braamfontein, 2017

31 De Korte Street, Braamfontein, Johannesburg, 2001

Tel. (011 703-7000 / Fax. (011) 339-1380

E-Mail: [email protected]

Website: www.nbcrfi.org.za

 

 

1.Full names of Employee …………..........2.   Identity No: …………………

 

 

3.Clock No. ………………………………    4.  Computer No.……………….

 

 

5.Period of absence from work ………………… to ……………………….. inclusive

 

 

6.Period of absence by doctor as per sick note ……………… to………………. inclusive

 

 

7.Did injury occur on duty          Yes        No

 

 

If to be paid directly into bank account in employee’s own name, please supply details:

Bank name

Type of account

Current

1

Savings

2

Transmission

3

Branch name

Branch Code

Account No.

 

 

I/We certify that the abovementioned details are true and correct.

 

 

 

 

Stamp of Company

 

 

Date ...............................................….

 

 

Place .........................................……..

 

N.B.

 

Original doctor’s note must be attached to this application.

 

[Annexure A.8 of Prescribed forms substituted by Notice No. 426, GG42312, dated 15 March 2019]