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  • Loa July 3, 2021

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    Daniel Ambrocio
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    Glory Mae C. Gayeta has submitted a leave of absence form to take one day of bereavement leave on July 3, 2021 to attend to her child. The form has been approved by her immediate supervisor Daniel B. Ambrocio. It specifies her leave credits, the inclusive dates of her requested leave, and the reason for taking leave. The human resources department will track her leave usage and note her return to work date.

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    LOA

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    LOA JULY 3, 2021

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    Glory Mae C. Gayeta has submitted a leave of absence form to take one day of bereavement leave on July 3, 2021 to attend to her child. The form has been approved by her immediate supervisor Daniel B. Ambrocio. It specifies her leave credits, the inclusive dates of her requested leave, and the reason for taking leave. The human resources department will track her leave usage and note her return to work date.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    22 views1 page

    Loa July 3, 2021

    Uploaded by

    Daniel Ambrocio
    Glory Mae C. Gayeta has submitted a leave of absence form to take one day of bereavement leave on July 3, 2021 to attend to her child. The form has been approved by her immediate supervisor Daniel B. Ambrocio. It specifies her leave credits, the inclusive dates of her requested leave, and the reason for taking leave. The human resources department will track her leave usage and note her return to work date.

    Copyright:

    © All Rights Reserved
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    of 1

    OUR LADY OF PERPETUALSUCCOR COLLEGE OUR LADY OF PERPETUALSUCCOR COLLEGE

    LEAVE OF ABSENCE FORM LEAVE OF ABSENCE FORM


    HR Copy HR Copy
    GLORY MAE C. GAYETA
    Name: ______________________________________ Date Filed: ________________________ JUNE 30, Date
    Name: ______________________________________ 2021 Filed: ________________________
    611-12016 REG.
    Employee No.: ________________ Dept.: _________ Position: __________________________ OFFICE ASSISTANT
    Employee No.: ________________ Dept.: _________ Position: __________________________
    CHECK PROPER BOX FOR TYPE OF LEAVE CHECK PROPER BOX FOR TYPE OF LEAVE
    Sick Maternity/ Paternity Wedding Solo Parent Bereavement Others Sick Maternity/ Paternity Wedding Solo Parent √
    Bereavement Others
    CERTIFICATION OF LEAVE CREDITS (HR) LEAVE/S TO BE TAKEN CERTIFICATION OF LEAVE CREDITS (HR) LEAVE/S TO BE TAKEN
    Allowable Leave: Validated by: Inclusive Date/s: Allowable Leave: Validated by: Inclusive Date/s:
    Leave Used: JULY 3, 2021
    Leave Used:
    Balance: HR Dept. No. of Day/s: Balance: HR1Dept. No. of Day/s:
    REASON/S REASON/S
    ATTEND TO MY CHILD

    Foreseen √ Unforeseen Excused Unexcused √ Foreseen Unforeseen Excused Unexcused


    Requested by: Approved By: Requested by: Approved By:
    GLORY MAE C. GAYETA DANIEL B. AMBROCIO, LPT, MAEd
    EMPLOYEE IMMEDIATE SUPERVISOR EMPLOYEE IMMEDIATE SUPERVISOR
    Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
    TO BE FILLED UP BY HR: TO BE FILLED UP BY HR:
    HR Remarks: Returned to work: HR Remarks: Returned to work:

    REVISED: AUGUST 2019 REVISED: AUGUST 2019

    OUR LADY OF PERPETUALSUCCOR COLLEGE OUR LADY OF PERPETUALSUCCOR COLLEGE


    LEAVE OF ABSENCE FORM LEAVE OF ABSENCE FORM
    Employee's Copy Employee's Copy
    GLORY MAE C. GAYETA
    Name: ______________________________________ Date Filed: ________________________ JUNE 30, Date
    Name: ______________________________________ 2021Filed: ________________________
    Employee No.: ________________611-12016 REG. Employee No.: ________________OFFICE
    Dept.: _________ Position: __________________________ Dept.: _________ASSISTANT
    Position: __________________________
    CHECK PROPER BOX FOR TYPE OF LEAVE CHECK PROPER BOX FOR TYPE OF LEAVE
    Sick Maternity/ Paternity Wedding Solo Parent Bereavement Others Sick Maternity/ Paternity Wedding Solo Parent √
    Bereavement Others
    CERTIFICATION OF LEAVE CREDITS (HR) LEAVE/S TO BE TAKEN CERTIFICATION OF LEAVE CREDITS (HR) LEAVE/S TO BE TAKEN
    Allowable Leave: Validated by: Inclusive Date/s: Allowable Leave: Validated by: Inclusive Date/s:
    Leave Used: JULY 3, 2021
    Leave Used:
    Balance: HR Dept. No. of Day/s: Balance: HR1Dept. No. of Day/s:
    REASON/S REASON/S
    ATTEND TO MY CHILD

    Foreseen √ Unforeseen Excused Unexcused √ Foreseen Unforeseen Excused Unexcused


    Requested by: Approved By: Requested by: Approved By:
    GLORY MAE C. GAYETA DANIEL B. AMBROCIO, LPT, MAEd
    EMPLOYEE IMMEDIATE SUPERVISOR EMPLOYEE IMMEDIATE SUPERVISOR
    Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
    TO BE FILLED UP BY HR: TO BE FILLED UP BY HR:
    HR Remarks: Returned to work: HR Remarks: Returned to work:

    REVISED: AUGUST 2019 REVISED: AUGUST 2019

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