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CS Form 6 (Application For Leave)

This document is an application for leave form containing details about the applicant, type of leave requested, and spaces for recommendations and approvals. The applicant provides their name, position, salary and other identifying details. They specify the type of leave (vacation, sick, etc.), the number of days requested, and inclusive dates. Spaces are included for the administrative officer and principal to provide recommendations on approving or disapproving the leave, and certifying the applicant's leave credits. The form notes policies around applying for different types of leave in advance and providing documentation like medical certificates.

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Noveric Olvida Desalisa
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© Attribution Non-Commercial (BY-NC)
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8K views

CS Form 6 (Application For Leave)

This document is an application for leave form containing details about the applicant, type of leave requested, and spaces for recommendations and approvals. The applicant provides their name, position, salary and other identifying details. They specify the type of leave (vacation, sick, etc.), the number of days requested, and inclusive dates. Spaces are included for the administrative officer and principal to provide recommendations on approving or disapproving the leave, and certifying the applicant's leave credits. The form notes policies around applying for different types of leave in advance and providing documentation like medical certificates.

Uploaded by

Noveric Olvida Desalisa
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 1984

1. OFFICE/AGENCY

APPLICATION FOR LEAVE


2. NAME:
(Last)

3. DATE OF FILING

6. a) TYPE OF LEAVE

4. POSITION

(First)

(Middle)

5. SALARY

(Monthly)

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

______Vacation

(1.) IN CASE OF VACATION LEAVE

______To seek employment


______Others (Specify)

______Within the Philippines


______Abroad (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
______Not 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:
________________________
________
________
________
________________________
________________________
Administrative Officer
7. c) APPROVED FOR:
________ days with pay
______________________________
________ days without pay
______________________________
________ others (Specify)

Principal

7. d) DISAPPROVED DUE TO:________

Date ___________
____________________________
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 filed in advance or 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 accompanied by a 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 be 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 accompanied by a clearance from
money

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