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CSC Form No 6 (NEW)

Madelin S. Ortega, a teacher at DepEd Calbayog III District, applied for vacation leave from January 13, 2017 to an unspecified end date. She is requesting to take her remaining sick leave credits of an unspecified number of days. The school principal and administrative officer recommended approval of the leave, while the public schools district supervisor will make the final determination.

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Madelin Sabonsolin Ortega
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290 views2 pages

CSC Form No 6 (NEW)

Madelin S. Ortega, a teacher at DepEd Calbayog III District, applied for vacation leave from January 13, 2017 to an unspecified end date. She is requesting to take her remaining sick leave credits of an unspecified number of days. The school principal and administrative officer recommended approval of the leave, while the public schools district supervisor will make the final determination.

Uploaded by

Madelin Sabonsolin Ortega
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CSC Form No.

6
(Revised as of March 2008 for Teaching Staff)

1.Office Agency:

2.

DepEd, Calbayog III District


3. Date of Filling: January 13, 2017
6. Type of Leave:
Vacation
To seek employment
Sick
Maternity
Others (Specify)

ORTEGA
MADELIN
SABONSOLIN
(Last Name)
(First Name)
(Middle)
4. Position: Teacher 5. 5. Salary(Monthly)
III
php 22,328.00
7. Where leave will be spent:
In case of Vacation Leave
Within the Philippines
Abroad (Specify)
_____________________
In case of Sick Leave
In Hospital (Specify)

________________________________________

___________________________________

Number of Working Days Applied


for:__________

___________________________________
Out Patient (Specify)

Inclusive Dates:
___________________________

___________________________________
___________________________________
Commutation:
Requested
Not
Requested

8. CERTIFICATION OF LEAVE CREDITS


As of _______________________________
Sick

Total

MADELIN S. ORTEGA
Printed Name & Signature of Applicant
9. Recommendations:
Approval
Disapproval
CRISANTO T. PACHO
Principal

EDITA S. CANO
Administrative Officer
V
10. Approved for:
_________ days with pay
_________ days without
pay

_________ other (specify)

Date: __________

SOLEDAD L. DERMAN
Public Schools District Supervisor
11. Disapproved due to:
_____________________
__________________________________
__________________________________
__________________________________

JOEL A. ZARTIGA, Ph.D.


OIC Assistant Schools Division Superintendent

________________________
Date
SPECIAL ORDER
No. ______________,s.20______
The application for _____ day/s ___________ leave of absence with/without pay
on_________ of ________________________, permanent national teacher of _________________,
Calbayog City is hereby approved.
This established a service credit balance of _______ day/s which maybe used to offset
future due to illness.
Director

By Authority of the DepEd Regional

JOEL A. ZARTIGA, Ph.D.

OIC Assistant Schools Division


Superintendent
Copy Furnished:
Teacher Concerned
Division Office File
Office File

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