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14 views

Leave Form

Uploaded by

mariszmina
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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CSC Form No.

36
Revised 1987

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

DOJ-OCP MAKATI LLANES LEILIA R.


3. DATE OF FILING 4. POSITION 5. SALARY (Monthly)

April 21, 2006 Assistant City Prosecutor

DETAILS OF APPLICATION

6. a.) TYPE OF LEAVE b.) WHERE LEAVE WILL BE SPENT

( x ) VACATION (1) IN CASE OF VACATION LEAVE


( ) To Seek employment ( ) Within the country _______________
( ) Others (Specify) _______________ ( ) Others (Specify) ________________

( ) SICK (2) IN CASE OF SICK LEAVE


( ) MATERNITY ( ) In Hospital (Specify)
( ) OTHERS (Specify) __________________________________
_________________ ( ) Out-patient (Specify)
__________________________________
c.) NUMBER OF WORKING d.) COMMUTATION
DAYS APPLIED FOR: ( ) Requested ( ) Not Requested

Seven (7) Days

Inclusive Dates

May 18, 19, 22, _____________________________________


23, 24, 25 and 26, 2006 Signature of Applicant

DETAILS OF ACTION ON APPLICATION

7. a.) CERTIFICATION OF LEAVE b.) RECOMMENDATION


CREDITS AS OF ( ) Approved ____________________________
______________________________ ( ) Disapproved due to
_______________________________________
______________________________________
: Vacation : Sick : Total :
: : : :
: : : :
_____________________________________
FELICIANO ASPI
______________________________________ City Prosecutor
ISABELITA V. MEJIA
Administrative Officer II

c.) APPROVED FOR: d.) DISAPPROVED DUE TO:

________________ Day (s) with pay _____________________________________________


________________ Day (s) without pay
________________ Others (Specify) _____________________________________________

_____________________________________ _____________________
Signature Date

_____________________________________
Authorized Official

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