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LEDESMA AUDIOLOGICAL CENTER, INC.

Personnel Form No.

Date: June 16, 2017

REQUEST FOR LEAVE OF ABSENCE

Name: Milagros A. Talisay Designation: Accountant

Department: Accounting Dept Location: Star Centrum

Date of Leave from June 17 only to __________________________

Reason: ______To attend to Basic Ecclesial Community seminar to be held at our Chapel. Our ___
__SPPC is the host of the seminar.____________________________________________
________________________________________________________________________

__________________________
Signature of Employee

Vacation Leave :_____(1)_________________ Sick Leave :_________________________

Available :_______________________ Available :_________________________

Balance :_______________________ Balance :_________________________

Verified : Approved by:

______________________
_______________________________________
DR. NELLY R. LEDESMA
Chairman / Audiologist

Remarks : ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

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