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Dilg Reports Resources 2018417 76002d33d9

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CSC Form 6

Revised 1998

APPLICATION FOR LEAVE


1. Office/Agency 2. Name (Last) (First) (Middle)

3. Date of Filing 4. Position 5. Salary

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


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 Sick Total Approval


Disapproval due to

Total

VERONICA B. MACABATE Authorized Official


OIC, Personnel Division
7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

Authorized Official

Date: _________________

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