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CSC Form 6 Application For Leave

1. Teacher Alex Sanchez of Cabuyao City Schools Division applied for 7 days of paternity leave from October 4-12, 2021. 2. The application was recommended for approval by Administrative Officer Jhoanna Manzano and will be authorized by Division Superintendent Neil Angeles. 3. The document provides the standard application form and process for requesting and approving leaves of absence for teachers and staff of the Cabuyao City Schools Division.

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alex
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5K views

CSC Form 6 Application For Leave

1. Teacher Alex Sanchez of Cabuyao City Schools Division applied for 7 days of paternity leave from October 4-12, 2021. 2. The application was recommended for approval by Administrative Officer Jhoanna Manzano and will be authorized by Division Superintendent Neil Angeles. 3. The document provides the standard application form and process for requesting and approving leaves of absence for teachers and staff of the Cabuyao City Schools Division.

Uploaded by

alex
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Republic of the Philippines


Department of Education
REGION IV-A CALABARZON
CITY SCHOOLS DIVISION OF CABUYAO

APPLICATION FOR LEAVE


1. OFFICE/DEPARTMENT 2. NAME : (Last) (First)

SANCHEZ, ALEX SOLLEZA

October 4- 12, 2021


3. DATE OF FILING ______________ Teacher III
4. POSITION _____________________________ 5. SA

6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Specia
Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292)

Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended)
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) ______________________
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave B
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) _________
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) ______________________
Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended)
Adoption Leave (R.A. No. 8552)
Other purpose:
Others:
Paternity Leave
_____________________________________

6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


7 DAYS
________________________________________
INCLUSIVE DATES
10- 4- 12, 2021
________________________________________
(Signature
7. DETAILS OF ACTION ON APPLICATION
7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
As of _______________________
Vacation Leave Sick Leave
Total Earned
Less this application
Balance

JHOANNA M. MANZANERO
JHOANNA M. MANZANERO
Administrative Officer IV (HRMO) Authorize
7.C APPROVED FOR: 7.D DISAPPROVED DUE TO
_______ days with pay
_______ days without pay
_______ others (Specify)

NEIL G. ANGELES, EdD


_________________________________
Authorized Signatory
Address: Cabuyao Enterprise Park, Cabuyao Athletes Basic School (CABS),
Brgy. Banay-Banay, Cabuyao City, Laguna
Telephone No.: (049) 545 4597 / (049) 545 4878
Email Address: [email protected]
Website: depedcabuyao.ph
Website: depedcabuyao.ph
Republic of the Philippines
artment of Education Stamp of Date of Receipt

EGION IV-A CALABARZON


CHOOLS DIVISION OF CABUYAO

CATION FOR LEAVE


ME : (Last) (First) (Middle)

SANCHEZ, ALEX SOLLEZA


Teacher III
SITION _____________________________ P 25, 232
5. SALARY _______________

DETAILS OF APPLICATION
6.B DETAILS OF LEAVE

In case of Vacation/Special Privilege Leave:


Within the Philippines __________________________
Abroad (Specify) _____________________________
In case of Sick Leave:
In Hospital (Specify Illness) _____________________
Out Patient (Specify Illness) ____________________
_____________________________________________
In case of Special Leave Benefits for Women:
(Specify Illness) ________________________________
_____________________________________________
In case of Study Leave:
Completion of Master's Degree
BAR/Board Examination Review
Other purpose:
Monetization of Leave Credits
Terminal Leave

6.D COMMUTATION
Not Requested
Requested

(Signature of Applicant)
LS OF ACTION ON APPLICATION
7.B RECOMMENDATION
For approval
For disapproval due to ________________________
___________________________________________
___________________________________________
___________________________________________

MA. NINA S. GACHE


___________________________________________
Authorized Signatory
7.D DISAPPROVED DUE TO:
_______________________________________
___________________________________________
___________________________________________

EIL G. ANGELES, EdD


____________________________
Authorized Signatory
Athletes Basic School (CABS),
aguna
5 4878
.gov.ph
AUTHORIZED SIGNATORIES (DepEd Order No. 2, s. 2021)

Up to 60 Calendar days More than 60 Calendar Days to One (1) Year


OFFICE/POSITION
Recommending Approval Approval Recommending Approval Approval

DIVISION OFFICE

SDS / ASDS ARD RD ARD RD

Division Chief ASDS SDS ASDS SDS

Below Division Chief* Division Chief ASDS Division Chief and ASDS SDS

SCHOOL

Principal / Head Teachers / TIC ASDS SDS ASDS SDS

Teachers and non-teaching personnel School Head ASDS School Head and ASDS SDS
*Applications of employees under the direct supervision of the RD / SDS shall be recommended by the ARD / ASDS and approved by the RD / SDS,
respectively

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