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Conalum Elem. School/Dep - Ed Inopacan Cubian Rubie Ann II Danzalan

Danzalan Cubian, an elementary school teacher, applied for vacation leave to spend time in Rubie Ann II within the Philippines. He requested leave for an unspecified number of days within inclusive dates. His application was recommended for approval by his immediate supervisor and authorized official, pending certification of his leave credits.

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35 views

Conalum Elem. School/Dep - Ed Inopacan Cubian Rubie Ann II Danzalan

Danzalan Cubian, an elementary school teacher, applied for vacation leave to spend time in Rubie Ann II within the Philippines. He requested leave for an unspecified number of days within inclusive dates. His application was recommended for approval by his immediate supervisor and authorized official, pending certification of his leave credits.

Uploaded by

rubieann_danzalan
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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CS Form 6

Revised 1994

1. OFFICE/AGENCY

APPLICATION FOR LEAVE


2. NAME:
(Last)
(First)

(Middle)

Cubian

Danzalan

Conalum Elem. School/Dep.Ed Inopacan

3. DATE OF FILING

6. a) TYPE OF LEAVE
[ ]

4. POSITION

[
[
[

5. SALARY (Monthly)

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

Vacation
[
[

Rubie Ann II

1.) IN CASE OF VACATION LEAVE

] To seek employment
] Others (Specify)
_________________
]Sick
] Maternity
] Others (Specify) _________

6. c) NUMBER OF DAYS APPLIED FOR


_________________________________
INCLUSIVE DATES ______________
_________________________________

[
[

] Within the Philippines


] Abroad (Specify) _______________________
______________________________________
2.) IN CASE OF SICK LEAVE
[ ] Hospital (Specify) ______________________
[ ] Out Patient (Specify) ____________________
6. d) COMMUTATION
[ ] Requested

] Not Requested

____________________________________
(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION


7. a) CERTIFICATION OF LEAVE CREDITS
7. b) RECOMMENDATION
AS OF ________________________________
[ ] Approval
[ ] Disapproval due to __________
Vacation:
Sick:
Total:
______days ________ days_______days
_____________________________
HRMO I
7.c. APPROVED FOR:
________ days with pay
________ days without pay
________ others (Specify)

_______________________
Immediate Supervisor

7. d) DISAPPROVED DUE TO:


______________________________
______________________________

____________________________
AUTHORIZED OFFICIAL
Date ___________

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