Application For Leave: 6B Where Leave Will Be Spent 6A Type of Leave

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APPLICATION FOR LEAVE

1 OFFICE AGENCY DEPED Santiago City 3 DATE OF FILING Sept. 23, 2012 2 NAME (Last) Villanueva 4 POSITION Teacher III (First) Wilma (Middle) Cerezo 5 SALARY (Monthly)

DETAILS OF APPLICATION
6A TYPE OF LEAVE
FALSE FALSE FALSE FALSE TRUE Vacation Employment Sick Maternity/Paternity Others (Specify)

6B WHERE LEAVE WILL BE SPENT


(1) In case of vacation leave Abroad (Specify) Within Philippines (2) In case of sick leave In-Hospital (Specify) Out Patient (Specify)

Special LeavePrivilage 6C NUMBER OF WORKING DAYS


Applied for

6D COMMUTATION
FALSE FALSE Requested Not Requested

Inclusive Dates

Sept. 23, 2012

WILMA C. VILLANUEVA (Signature of Applicant) 7B RECOMMENDATION


FALSE FALSE Approval Disapproval due to

7A CERTIFICATION OF LEAVE CREDITS As of April 30, 2011


Vacation Sick Total

0 0 0 7C APPROVED FOR Days with pay Days without Pay Others (Specify)

7D DISAPPROVED DUE TO

PERFECTA B. GARCIA, Ph. D. Principal

Signature Asst. Schools Division Superintendent - OIC

CS Form 6 Revised 1984

APPLICATION FOR LEAVE


1 OFFICE AGENCY DEPED Santiago City 3 DATE OF FILING Sept. 23, 2012 2 NAME (Last) Villanueva 4 POSITION Teacher III (First) Wilma (Middle) Cerezo 5 SALARY (Monthly)

DETAILS OF APPLICATION
6A TYPE OF LEAVE
Vacation Employment Sick Maternity/Paternity Others (Specify)

6B WHERE LEAVE WILL BE SPENT


(1) In case of vacation leave Abroad (Specify) Within Philippines (2) In case of sick leave In-Hospital (Specify) Out Patient (Specify)

Special LeavePrivilage 6C NUMBER OF WORKING DAYS


Applied for

6D COMMUTATION
Requested Not Requested

Inclusive Dates

Sept. 23, 2012

(Signature of Applicant) 7B RECOMMENDATION


Approval Disapproval due to

7A CERTIFICATION OF LEAVE CREDITS As of


Vacation Sick Total

7C APPROVED FOR Days with pay Days without Pay Others (Specify)

7D DISAPPROVED DUE TO

PERFECTA B. GARCIA, Ph. D. Principal

Signature Asst. Schools Division Superintendent - OIC

Teacher I Teacher II Teacher III Master Teacher I Master Teacher II Head Teacher I Head Teacher II Head Teacher III Principal I Principal II Principal III Principal IV EPS I Administrative Officer

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