APPLICATION FOR LEAVE

C.S.C. FORM 6

APPLICATION FOR LEAVE

C.S.C. FORM 6

1. NATIONAL ARCHIVES OF THE

PHILIPPINES

2. NAME: Last

3. Date of filing:

4. Position

First

FERRER

MERLITO
5. Monthly Salary:

Adm Aide I

October 28, 2016

DETAILS APPLICATION
6. a) TYPE OF LEAVE:
( ) VACATION
( ) to seek employment
( ) others ( Specify) ___________
________________________________

1. NATIONAL ARCHIVES OF THE

PHILIPPINES

2. NAME: Last

3. Date of filing:

4. Position

M.

( 2 ) IN CASE OF SICK LEAVE

( ) In Hospital (Specify) ________

6. a) TYPE OF LEAVE:
( ) VACATION
( ) to seek employment
( ) others ( Specify) ___________
________________________________

ONE DAY

6.c) NO. OF WORKING DAYS APPLIED

October 27, 2016

Inclusive Days

Sick

MAITA E. ABUNALES
Administrative Officer V
7.c) Approved for:
__________ day/s with pay
__________ days/s without pay
__________ Others (Specify)

Total

7.d) Disapproved due to:

_________________________________
_________________________________
_________________________________

VICTORINO MAPA MANALO, C E.S.E

Executive Director

6. a) TYPE OF LEAVE:
( ) VACATION
( ) to seek employment
( ) others ( Specify) ___________
________________________________
( x ) SICK
( ) MATERNITY
( ) OTHERS ( Specify )___________

Sick

MAITA E. ABUNALES
Administrative Officer V
7.c) Approved for:
__________ day/s with pay
__________ days/s without pay
__________ Others (Specify)

6.c) NO. OF WORKING DAYS APPLIED

ONE DAY

( ) Not Requested

October 27, 2016

Inclusive Days

7.a)CERTIFICATION OF LEAVE CREDITS

AS of___________________________

Vacation

MICHAEL C. FRANCISCO
Authorized Official/Division Chief

6.d) COMMUTATION:
( ) Requested

ONE DAY

Inclusive Days

Vacation

3. Date of filing:

Backache

October 27, 2016

7.a)CERTIFICATION OF LEAVE CREDITS
AS of___________________________

M.

( ) Out Patient ___________________

( ) Not Requested

Signature of Applicant
7.b) RECOMMENDATION:
( ) Approved
( ) Disapproved due to ____________

1. NATIONAL ARCHIVES OF THE

PHILIPPINES

October 28, 2016

DETAILS APPLICATION

( 2 ) IN CASE OF SICK LEAVE

( ) In Hospital (Specify) ________

Backache
6.d) COMMUTATION:
( ) Requested

MERLITO

6.b) WHERE LEAVE WILL BE SPENT:

( 1 ) IN CASE OF VACATION LEAVE:
( ) Within the Philippines
( ) Abroad (Specify) ___________

( x ) SICK
( ) MATERNITY
( ) OTHERS ( Specify )___________

M.I.

5. Monthly Salary:

Adm Aide I

( ) Out Patient ___________________

6.c) NO. OF WORKING DAYS APPLIED

First

FERRER

October 28, 2016

DETAILS APPLICATION

6.b) WHERE LEAVE WILL BE SPENT:

( 1 ) IN CASE OF VACATION LEAVE:
( ) Within the Philippines
( ) Abroad (Specify) ___________

( x ) SICK
( ) MATERNITY
( ) OTHERS ( Specify )___________

M.I.

APPLICATION FOR LEAVE

C.S.C. FORM 6

Signature of Applicant
7.b) RECOMMENDATION:
( ) Approved
( ) Disapproved due to ____________

Total

7.a)CERTIFICATION OF LEAVE CREDITS

AS of___________________________

Vacation

MICHAEL C. FRANCISCO
Authorized Official/Division Chief
7.d) Disapproved due to:
_________________________________
_________________________________
_________________________________

VICTORINO MAPA MANALO, C E.S.E

Executive Director

Sick

Total

MAITA E. ABUNALES
Administrative Officer V
7.c) Approved for:
__________ day/s with pay
__________ days/s without pay
__________ Others (Specify)

VICTORINO MAPA MANAL

Executive Di

Please see instructions at the back

Please see instructions at the back

Please see instructions at the back

2. NAME: Last

First

FERRER
4. Position

MERLITO
5. Monthly Salary:

Adm Aide I
6.b) WHERE LEAVE WILL BE SPENT:
( 1 ) IN CASE OF VACATION LEAVE:
( ) Within the Philippines
( ) Abroad (Specify) ___________

( 2 ) IN CASE OF SICK LEAVE

( ) In Hospital (Specify) ________
( ) Out Patient ___________________

Backache
6.d) COMMUTATION:
( ) Requested
( ) Not Requested

Signature of Applicant
7.b) RECOMMENDATION:
( ) Approved
( ) Disapproved due to _____________

MICHAEL C. FRANCISCO
Authorized Official/Division Chief
7.d) Disapproved due to:
_________________________________
_________________________________
_________________________________

VICTORINO MAPA MANALO, C E.S.E

Executive Director

M.I.

M.

INSTRUCTIONS:
1. Applications for vacation or sick leave for one full
day or more shall be made on this form and
accomplish at least in triplicate.
2. Application for vacation leave shall be filed in
advance or whenever possible five (5) days before
going on such leave.
3. Application for sick leave in advance or exceeding
five (5) days shall be accompanied by a medical
certificate. In case medical consultant 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/her authorized
leave of absence.
5. An application of leave of absence for thirty (30)
calendar days or more shall be accompanied by
clearance from money and property accountability.

INSTRUCTIONS:
1. Applications for vacation or sick leave for one full
day or more shall be made on this form and
accomplish at least in triplicate.
2. Application for vacation leave shall be filed in
advance or whenever possible five (5) days before
going on such leave.
3. Application for sick leave in advance or exceeding
five (5) days shall be accompanied by a medical
certificate. In case medical consultant 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/her authorized
leave of absence.
5. An application of leave of absence for thirty (30)
calendar days or more shall be accompanied by
clearance from money and property accountability.

INSTRUCTIONS:
1. Applications for vacation or sick leave for one full
day or more shall be made on this form and
accomplish at least in triplicate.
2. Application for vacation leave shall be filed in
advance or whenever possible five (5) days before
going on such leave.
3. Application for sick leave in advance or exceeding
five (5) days shall be accompanied by a medical
certificate. In case medical consultant 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/her authorized
leave of absence.
5. An application of leave of absence for thirty (30)
calendar days or more shall be accompanied by
clearance from money and property accountability.