CLASS D CLASS D

SF-46
SF-46
REVISION DATE: OCT. 16, 2023
REVISION DATE: OCT. 16, 2023

APPLICATION FOR LEAVE APPLICATION FOR LEAVE

Name: Date of Filing:
Name: Date of Filing:
LAST NAME FIRST NAME MIDDLE INITIAL
LAST NAME FIRST NAME MIDDLE INITIAL Office/Unit: Position/Status of Employment ID No. Salary
Office/Unit: Position/Status of Employment ID No. Salary

DETAILS OF APPLICATION
DETAILS OF APPLICATION Type Of Leave: Where Leave Will Be Spent:
Type Of Leave: Where Leave Will Be Spent:
Vacation Leave In case of Vacation Leave
Vacation Leave In case of Vacation Leave
Sick Leave Within the Philippines
Sick Leave Within the Philippines
Others (Please Specify) Abroad (Please Specify)
Others (Please Specify) Abroad (Please Specify)

No. of Work Days Applied: In case of Sick Leave

No. of Work Days Applied: In case of Sick Leave
Working Day(s) In Hospital (Specify)
Working Day(s) In Hospital (Specify)

Inclusive Date(s):
Inclusive Date(s): Out Patient (Specify)
Out Patient (Specify)

Signature of Applicant Signature of Applicant

DETAILS OF ACTION ON APPLICATION

DETAILS OF ACTION ON APPLICATION
Balance of Leave as of Recommendation
Balance of Leave as of Recommendation
Approval
Approval
VL SL TOTAL Disapproval (Specify)
VL SL TOTAL Disapproval (Specify)
DAYS DAYS DAYS
DAYS DAYS DAYS

Immediate Supervisor
Immediate Supervisor HR Personnel
HR Personnel
APPROVED DISAPPROVED
APPROVED DISAPPROVED

Authorized Signatory
Authorized Signatory
CLASS D CLASS D
SF-46
SF-46
REVISION DATE: OCT. 16, 2023
REVISION DATE: OCT. 16, 2023

INSTRUCTIONS
INSTRUCTIONS
1. Application for vacation and sick leave for one full day or more shall be made on this Form
1. Application for vacation and sick leave for one full day or more shall be made on this Form
2. Application for Leave shall be filed in two (2) copies.
2. Application for Leave shall be filed in two (2) copies.
File Copy 1 - for Administrative Services Department
File Copy 1 - for Administrative Services Department
File Copy 2 - for Employee
File Copy 2 - for Employee
3. Application for Vacation Leave shall be filed in advance, or not later than five (5) working days before going
3. Application for Vacation Leave shall be filed in advance, or not later than five (5) working days before going
on such leave.
on such leave.
4. Application for sick leave file in advance, or exceeding five (5) working days shall be accompanied by a
4. Application for sick leave file in advance, or exceeding five (5) working days shall be accompanied by a
medical certificate.
medical certificate.
5. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to
5. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to
the period of his/her unauthorized leave of absence.
the period of his/her unauthorized leave of absence.
6. An application of leave of absence for thirty (30) calendar days or more shall be accompanied by a
6. An application of leave of absence for thirty (30) calendar days or more shall be accompanied by a
clearance from money and property accountabilities. Availed vacation or sick leave of less than thirty (30)
clearance from money and property accountabilities. Availed vacation or sick leave of less than thirty (30)
calendar days but subsequent extended to more than thirty (30) calendar days shall also be required to secure
calendar days but subsequent extended to more than thirty (30) calendar days shall also be required to secure
clearance.
clearance.
7. Approval of leave application shall be in accordance with LBRDC Codified Approving and Signing Authority
7. Approval of leave application shall be in accordance with LBRDC Codified Approving and Signing Authority
(CASA).
(CASA).