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Application For Leave: Cortes Jocelyn Rapas

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CSC Form 6

Revised 1998

APPLICATION FOR LEAVE


1. Office/Agency 2. Name (Last) (First) (Middle)
DEPED TAGBINA I - QUARY I IS CORTES JOCELYN RAPAS
3. Date of Filing 4. Position 5. Salary
TEACHER 1 20,179.00
DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave


Maternity In hospital (Specify)
Others (Specify)
HOME MEDICATION

6. C) Number of Working Days applied for: 6. D) Commutation


Requeste Not Requested
Inclusive Dates

Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A) Certification of Leave Credits 7. B) Recommendation:
as of

Vacation Sick Total Approval


Disapproval due to
days days days

LUZVIMINDA M. EBONA KIRK ANDREW B. ABELLANOSA - SP 1


Authorized Official Authorized Official
7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

MARILOU B. DEDUMO, Ph.D, CESO V


Schools Division Superintendent

Date: _________________
CSC Form 6
Revised 1998

APPLICATION FOR LEAVE


1. Office/Agency 2. Name (Last) (First) (Middle)
DEPED TAGBINA I - QUARY I IS CORTES JOCELYN RAPAS
3. Date of Filing 4. Position 5. Salary
12-Dec-18 TEACHER 1 20, 179.00
DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave


Maternity In hospital (Specify)
Others (Specify)

6. C) Number of Working Days applied for: 6. D) Commutation


60 days Requeste Not Requested
Inclusive Dates
January 21, 2019 - March 21, 2019
Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A) Certification of Leave Credits 7. B) Recommendation:
as of

Vacation Sick Total Approval


Disapproval due to
days days days

EPPIE C. CABRERA KIRK ANDREW B. ABELLANOSA - SP 1


Authorized Official Authorized Official
7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

MARILOU B. DEDUMO, Ph.D, CESO V


Schools Division Superintendent

Date: _________________

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