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C.S. Form No.

6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (Last) (First) (Middle) EMPLOYEE NO.


Team 26-CITY OF CABANATUAN GARCIA, MA. JOSERET JANE JAVATE 0259594
3. DATE OF FILING 4. POSITION 5. SALARY
January 24, 2019 SA II P42,099.00

DETAILS OF APPLICATION

6. a) TYPE OF LEAVE (6.b.) WHERE LEAVE WILL BE SPENT:


( X ) Vacation (b.1.) IN CASE OF VACATION LEAVE
( To seek employment ( ) Within the Philippines
( XOthers (Specify) Forced Leave ( X ) Abroad (Specify) South Korea

( ) Sick (b.2.) IN CASE OF SICK LEAVE


( ) Maternity ( ) In Hospital (Specify)
( ) Others (Specify)
( ) Out Patient (Specify)

(6.c.) NUMBER OF WORKING DAYS APPLIED (6.d.) COMMUTATION


FOR Three (3) day/s ( ) Requested
INCLUSIVE DATES ( ) Not Requested
April 24-28, 2019

MA. JOSERET JANE J. GARCIA


(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

(7.a.) CERTIFICATION OF LEAVE CREDITS (7.b.) RECOMMENDATION


AS OF __________________________ ( ) Approval
( )

Vacation Sick Total

Days Days Days DANILO E. YACAT


State Auditor IV/Audit Team Leader
(SIGNATURE)

(Personnel Officer)

(7.c.) APPROVED FOR: (7.d.) DISAPPROVED DUE TO:


3 days with pay
days without pay
Others (Specify)

EMMA R. INOS-TALENS
State Auditor V/Supervising Auditor
____________________________________________
(SIGNATURE)
(AUTHORIZED OFFICIAL)

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