CSC FORM NO.

6
Revised 1984
APPLICATION FOR LEAVE
(FOR TEACHERS)
1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (M.I.)
DEPED GUIJOVA RULINA D
3. DATE OF FILING 4. POSITION 5. SALARY (Monthly)
TEACHER III
DETAILS OF APPLICATION
6.a) TYPE OF LEAVE 6.B) WHERE LEAVE WILL BE SPENT
1. In case of vacation leave
Vacation Within the Philippines
To seek employment Abroad (Specify)
Others (Specify)
2. In case of Sick Leave
Sick In Hospital (Specify)
Maternity
Others (Specify) Out-Patient (Specify)

6.d) COMMUTATION
6. c) NUMBER OF WORKING DAYS APPLIED FOR
Requested Not Requested
INCLUSIVES DATES
RULINA D. GUIJOVA
Signature
DETAILS OF ACTION ON APPLICATION
7.a) CERTIFICATION OF LEAVE CREDITS 7.b) RECOMMENDATION
as of
Approval
Disapproval due to
Vacation Sick Total

REYNALDO C. BULAHAN
School Head
MA. SHARON S. BARRIENTOS
Administrative Officer IV (PERSONNEL) HRMO II

7.c) APPROVED FOR 7.d)DISAPPROVED DUE TO:

days with pay
days without pay
others (specify)

LUZ U. BANSON EdD, CESE

OIC - Asst. Schools Division Superintendent
Date:

INSTRUCTION
1. Application for vacation or sick leave for one full day shall be made on this Form to accomplished at least in duplicate.
2. Application for vacation leave shall be filled in advance or whatever 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 medical certificate. In caes medical consultation was 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/her salary corresponding to the period of his authorized leave of absence.
5. An application for Leave of Absence for 30 calendar days or more shall be accompanied by clearance from money and property accountabilities.
CSC FORM NO. 6
Revised 1984
APPLICATION FOR LEAVE
(FOR SCHOOL HEADS)
1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (M.I.)
DepEd NAELGAS ROBERT0 0
3. DATE OF FILING 4. POSITION 5. SALARY (Monthly)
February 13, 2023 MASTER TEACHER I 47,738.00
DETAILS OF APPLICATION
6.a) TYPE OF LEAVE 6.B) WHERE LEAVE WILL BE SPENT
1. In case of vacation leave
Vacation Within the Philippines
To seek employment Abroad (Specify)
Others (Specify)
2. In case of Sick Leave
Sick In Hospital (Specify)
Maternity
Others (Specify) Out-Patient (Specify)

6.d) COMMUTATION
6. c) NUMBER OF WORKING DAYS APPLIED FOR
Requested Not Requested
INCLUSIVES DATES
February 13-14, 2023 ROBERTO O. NAELGAS
Signature
DETAILS OF ACTION ON APPLICATION
7.a) CERTIFICATION OF LEAVE CREDITS 7.b) RECOMMENDATION
as of
Approval
Disapproval due to
Vacation Sick Total

MA. SHARON S. BARRIENTOS

Administrative Officer IV (PERSONNEL) HRMO II

7.c) APPROVED FOR 7.d)DISAPPROVED DUE TO:

days with pay

days without pay
others (specify)

MA. LUNIE B. SAMPANI

OIC - Asst. Schools Division Superintendent
Date:

INSTRUCTION
1. Application for vacation or sick leave for one full day shall be made on this Form to accomplished at least in duplicate.
2. Application for vacation leave shall be filled in advance or whatever 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 medical certificate. In case medical consultation was 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/her salary corresponding to the period of his authorized leave of absence.
5. An application for Leave of Absence for 30 calendar days or more shall be accompanied by clearance from money and property accountabilities.