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NEW Leave Form 2020

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CSC Form 6

Revised 1998

APPLICATION FOR LEAVE


1. Office / Agency 2. Name (Last) (First) (Middle)
DepEd Anhao Jodene Soronio

3. Date of Filing 4. Position 5. Salary


Feb. , 2020 T-1

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


_________1______________________ Requested Not Requested
Inclusive Dates

______Feb. 19, 2020__________ _______________________________


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

Vacation Sick Total


Approval
Balance:
DELMA R. DENAPO Disapproval due to
Administrative Officer Less: ____________________________
IV / HRMO
Total: days days days

MARGISSA T. AMEN
Administrative Officer V
7. C) Approved for: 7. D) Disapproved due to:

_______ days with pay _____________________________


_______ days without pay _____________________________

ROSEMARIE T. MACESAR
Assistant Schools Division Superintendent

Anecito St., Mantic, Tangub City


Website:
Telephone: (088) 545 - 0304
Telefax: (088) 395 - 3372
Date:______________

Anecito St., Mantic, Tangub City


Website:
Telephone: (088) 545 - 0304
Telefax: (088) 395 - 3372

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