CSC Form No.
6
Revised 1984
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED
Laur District
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:
Teacher lll
DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested
Inclusive Dates:
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7 a.) Certification of Leave Credits: 7 b.) Recommendation:
As of: ____________________________________________
VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________
Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________
BRENDA A. PADILLA
School Principal II
REYMO R. ALDAMA EDGARDO L. CAMACHO, Ph.D.
Administrative Officer IV District Supervisor
7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:
Day/s with Pay
Day/s without pay
Other/s (specify)
ORLANDO C. DE LEON
Administrative Officer V
CSC Form No. 6
Revised 1984
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:
P
DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested
Inclusive Dates:
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7 a.) Certification of Leave Credits: 7 b.) Recommendation:
As of: ____________________________________________
VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________
Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________
REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal
7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:
________ Day/s with Pay
________ Day/s without pay
________ Other/s (specify)
JOHANNA N. GERVACIO, Ph. D.
Asst. Schools Division Superintendent
GUIDELINES ON THE FILING OF APPLICATION
FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)
INSTRUCTIONS
1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and to be accomplished
at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on such leave.
3. Application for sick leave filed in advance, or exceeding five (5) days shall be accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
CSC Form No. 6
Revised 1984
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:
DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested
Inclusive Dates:
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7 a.) Certification of Leave Credits: 7 b.) Recommendation:
As of: ____________________________________________
VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________
Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________
REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal
7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:
Days with Pay
Days without pay
Others (specify)
ERICSON S. SABACAN, Ed. D.
Asst. Schools Division Superintendent
GUIDELINES ON THE FILING OF APPLICATION
FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)
INSTRUCTIONS
1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and to be accomplished
at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on such leave.
3. Application for sick leave filed in advance, or exceeding five (5) days shall be accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
CSC Form No. 6
Revised 1984
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED
(Last Name) (Given Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:
DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines ___________________
Others (specify) Abroad (Specify) ___________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) ___________________
Others (specify) __________________________ Out-Patient (specify) ___________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Reques
Inclusive Dates:
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7 a.) Certification of Leave Credits: 7 b.) Recommendation:
As of: ____________________________________________
VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ____________________________
Disapproved due to: ____________________________
______________ ______________ _______________ ____________________________
REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal
7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:
________ Day/s with Pay
________ Day/s without pay
________ Other/s (specify)
RONALDO A. POZON, Ph. D., CESO V
Schools Division Superintendent
GUIDELINES ON THE FILING OF APPLICATION
FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)
INSTRUCTIONS
1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and to be accomplished
at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on such leave.
3. Application for sick leave filed in advance, or exceeding five (5) days shall be accomplished by a medical certificate. In cas
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
(Middle Name)
_________________________
_________________________
_________________________
_________________________
_____ Not Requested
of Applicant)
____________________________
____________________________
____________________________
hool Principal
nd to be accomplished
e going on such leave.
a medical certificate. In case
onding to the period of his
by a clearance from money
CSC Form No. 6
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED
(Last ) (First) (Middle)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:
DETAILS OF APPLICATION
6 a.) TYPE OF LEAVE: 6 b.) WHERE LEAVE WILL BE SPENT:
_____ Vacation Leave 1.) IN CASE OF VACATION LEAVE:
_____ To seek employment Within the Philippines _________________________
____ Others (specify) Abroad (Specify) _________________________
MONETIZATION OF LEAVE CREDITS (MOLC)
_____ Sick Leave 2.) IN CASE OF SICK LEAVE:
_____ Maternity InHospital (specify) _________________________
_____ Others Out-Patient (specify) _________________________
6 c.) NUMBER OF WORKING DAYS; 6 d.) COMMUTATION:
APPLIED FOR: Days __/___ Requested _____ Not Requested
INCLUSIVE DAY/S:
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7 a.) CERTIFICATION OF LEAVE CREDITS: 7 b.) RECOMMENDATION:
As of:
VACATION SICK TOTAL
_____ APPROVED
_____ DISAPPROVED due to:
vvvvvvvv vvvvvvvv vvvvvvvv PSDS/School Principal
REYMO R. ALDAMA ORLANDO C. DE LEON
Administrative Officer IV Administrative Officer V
7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:
Day/s with Pay
________ Day/s without pay
________ Other/s (specify)
RONALDO A. POZON, Ph. D., CESO V
Schools Division Superintendent
rra.
