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    Leave Revised Floricel

    Uploaded by

    LJ Aggabao
    This document is a Civil Service Form No. 6 application for leave from the Southern Isabela Medical Center. [1] The applicant, an Admin Officer I, is applying for 1 day of Special Privilege Leave on May 24, 2022. [2] The form provides sections to fill in applicant details, type of leave requested, number of days, and certification of available leave credits. [3] The applicant has requested commutation of the leave, and the form provides sections for recommendation, approval or disapproval by authorized officers.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    Leave Revised Floricel

    Uploaded by

    LJ Aggabao
    49 views2 pages
    This document is a Civil Service Form No. 6 application for leave from the Southern Isabela Medical Center. [1] The applicant, an Admin Officer I, is applying for 1 day of Special Privilege Leave on May 24, 2022. [2] The form provides sections to fill in applicant details, type of leave requested, number of days, and certification of available leave credits. [3] The applicant has requested commutation of the leave, and the form provides sections for recommendation, approval or disapproval by authorized officers.

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    This document is a Civil Service Form No. 6 application for leave from the Southern Isabela Medical Center. [1] The applicant, an Admin Officer I, is applying for 1 day of Special Privilege Leave on May 24, 2022. [2] The form provides sections to fill in applicant details, type of leave requested, number of days, and certification of available leave credits. [3] The applicant has requested commutation of the leave, and the form provides sections for recommendation, approval or disapproval by authorized officers.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    49 views2 pages

    Leave Revised Floricel

    Uploaded by

    LJ Aggabao
    This document is a Civil Service Form No. 6 application for leave from the Southern Isabela Medical Center. [1] The applicant, an Admin Officer I, is applying for 1 day of Special Privilege Leave on May 24, 2022. [2] The form provides sections to fill in applicant details, type of leave requested, number of days, and certification of available leave credits. [3] The applicant has requested commutation of the leave, and the form provides sections for recommendation, approval or disapproval by authorized officers.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 2

    Civil Service Form No.

    6
    Revised 2020
    Republic of the Philippines
    Stamp of Date of Receipt
    SOUTHERN ISABELA MEDICAL CENTER

    Zamora St. Corner Recto Avenue, Rosario, Santiago City

    APPLICATION FOR LEAVE


    1. OFFICE/DEPARTMENT 2. NAME: (Last) (First) (Middle)

    CDU- FINANCE
    3. DATE OF FILING 4. POSITION ADMIN OFFICER I 5. SALARY PHP 22,190.00

    6. DETAILS OF APPLICATION
    6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

    Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

    Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) √ Within the Philippines

    Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify)

    Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
    Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness)
    √ Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness)
    Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) In case of Special Leave Benefits for Women:

    Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) (Specify Illness)
    10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) In case of Study Leave:

    Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Completion of Master's Degree

    Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) BAR/Board Examination Review Other

    Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) purpose:


    Adoption Leave (R.A. No. 8552) Monetization of Leave Credits

    Others: Terminal Leave

    6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION

    1 Day Not Requested

    INCLUSIVE DATES √ Requested


    May 24, 2022
    (Signature of Applicant)

    7. DETAILS OF ACTION ON APPLICATION


    7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION

    As of

    Vacation Leave Sick Leave For approval


    Total Earned
    For disapproval due to
    Less this application

    Balance - -
    CARLE FLORE V. DELA CRUZ, MBM
    HRMO-DESIGNATE
    Authorized Officer Authorized Officer

    7.C APPROVED FOR: 7. D DISAPPROVED DUE TO:

    days with pay

    days without pay

    others (Specify)
    Authorized Officer

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