Leave Form New.docx

CS Form 6 1. OFFICE AGENCY DepEd 3. DATE OF FILLING

APPLICATION FOR LEAVE 2. NAME: (Last) (First) 4. POSITION

(Middle) SALARY (Monthly) Php._____________________________

DETAILS OF APPLICATION 6. b) WHERE LEAVE BE SPENT:

6. a) TYPE OF LEAVE _______ Vacation

(1) IN CASE OF VACATION LEAVE

_______ To seek employment _______ Others (Specify)

_______ Within the Philippines _______ Others (Specify)

_______ Sick _______ Maternity _______ Others (Specify)

(2) IN CASE OF SICK LEAVE _______ Hospital (Specify) _______ Out Patient (Specify)

6. c) NUMBER OF DAYS APPLIED FOR _______ INCLUSIVE DATES ______________________

6. d) COMMUTATION _______ Requested _______

_______________________________________ (Signature of Applicant) Employee No. ___________________________ DETAILS OF ACTION ON APPLICATION 7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION AS OF ___________________________ _______ Approval _______ Disapproval due to ________________ Vacation Sick Total ________________________________ _______ _______ _______ _______________________________________ (Principal) ______________________________________ Administrative officer 7. c) APPROVED FOR _______ days with pay _______ days without pay _______ others (Specify)

7. d) DISAPPROVED DUE TO: _______________________________________ _______________________________________

Date: _________________________________

JOSE L. DONCILLO, CESO V Schools Division Superintendent 1. Application for vacation or sick leave for one full day or more shall be made on the Form and to be accomplished in duplicate. 2. application for vacation leave shall be filled in advance of whenever possible five (5) days before going on such leave. 3. application for sick leave filed in advance or exceeding five (5) days shall be accomplished by medical certificate. In case medical consultation were not availed of, an affidavit should be executed by the applicant. 4. an employee who is absent without approved leave shall not entitled to receive his salary corresponding the period of his unauthorized leave of absence. 5. an application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance form money.