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  • Application For Leave: Dela Cruz, Perla E. Principal II

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    Guia Marie Diaz Brigino
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    This document is an application for leave submitted by Aiza R. Garcia, an Administrative Officer II at the Elementary Schools Division of Pandi North in Bulacan. She is applying for sick leave from February 20-24, 2023 due to an unspecified illness. The application includes details of her position, salary, type of leave requested, and dates of leave. It requires certification of her leave credits and recommendations for approval or disapproval from the Human Resource Management Officer and Assistant Schools Division Superintendent before the final approval or disapproval by the Schools Division Superintendent.

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    This document is an application for leave submitted by Aiza R. Garcia, an Administrative Officer II at the Elementary Schools Division of Pandi North in Bulacan. She is applying for sick leave from February 20-24, 2023 due to an unspecified illness. The application includes details of her position, salary, type of leave requested, and dates of leave. It requires certification of her leave credits and recommendations for approval or disapproval from the Human Resource Management Officer and Assistant Schools Division Superintendent before the final approval or disapproval by the Schools Division Superintendent.

    Copyright:

    © All Rights Reserved
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    87 views6 pages

    Application For Leave: Dela Cruz, Perla E. Principal II

    Uploaded by

    Guia Marie Diaz Brigino
    This document is an application for leave submitted by Aiza R. Garcia, an Administrative Officer II at the Elementary Schools Division of Pandi North in Bulacan. She is applying for sick leave from February 20-24, 2023 due to an unspecified illness. The application includes details of her position, salary, type of leave requested, and dates of leave. It requires certification of her leave credits and recommendations for approval or disapproval from the Human Resource Management Officer and Assistant Schools Division Superintendent before the final approval or disapproval by the Schools Division Superintendent.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 6

    Civil Service Form No.

    6
    Revised 2020

    Republic of the Philippines


    DEPARTMENT OF EDUCATION Stamp of Date of Receipt
    SCHOOLS DIVISION OF BULACAN

    APPLICATION FOR LEAVE


    1. OFFICE/DEPARTMENT 2. NAME : (Last) (First) (Middle)
    (ELEMENTARY) DEPED PANDI NORTH DELA CRUZ, PERLA E.

    December 21, 2022 Principal II P 56,633.00


    3. DATE OF FILING ___________________ 4. POSITION _____________________________ 5. SALARY _______________

    6. DETAILS OF APPLICATION
    6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

    Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

    P Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________

    Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) _____________________________
    Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
    Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) _____________________
    Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness) ____________________
    Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) _____________________________________________
    Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
    10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) ________________________________
    Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) _____________________________________________
    Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
    Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
    Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
    Other purpose:
    Others: Monetization of Leave Credits
    _____________________________________ Terminal Leave

    6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


    1 day
    ________________________________________ Not Requested
    INCLUSIVE DATES P Requested
    December 29, 2022 ___________________ 4332172
    ________________________________________
    (Signature of Applicant) Employee No.

    7. DETAILS OF ACTION ON APPLICATION


    7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
    As of _______________________ P For approval
    Vacation Leave Sick Leave For disapproval due to ________________________
    Total Earned
    Less this application
    Balance

    VICTORIA O. MADRIGAL ZUREX T. BACAY, PhD.


    Administrative Officer IV (HRMO) Assistant School Division Superintendent

    7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:


    _______ days with pay _______________________________________
    _______ days without pay ___________________________________________
    _______ others (Specify) ___________________________________________

    ROWENA T. QUIAMBAO, CESO VI


    Assistant ZENIA
    SchoolsG. MOSTOLES,
    Division EdD, CESO V
    Superintendent
    Schools Division Superintendent
    Officer-In-Charge
    Schools
    Office of the School Division
    Division of Bulacan
    Superintendent
    Civil Service Form No. 6
    Revised 2020

    Republic of the Philippines


    DEPARTMENT OF EDUCATION Stamp of Date of Receipt
    SCHOOLS DIVISION OF BULACAN

    APPLICATION FOR LEAVE


    1. OFFICE/DEPARTMENT 2. NAME : (Last) (First) (Middle)
    (ELEMENTARY) DEPED PANDI NORTH GARCIA, AIZA R.

    February 20, 2023 Administrative Officer II 27,000.00


    3. DATE OF FILING _________________ 4. POSITION _____________________________ 5. SALARY _______________

    6. DETAILS OF APPLICATION
    6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

    Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

    Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________

    P Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) _____________________________
    Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
    Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) _____________________
    Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness) ____________________
    Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) _____________________________________________
    Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
    10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) ________________________________
    Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) _____________________________________________
    Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
    Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
    Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
    Other purpose:
    Others: Monetization of Leave Credits
    _____________________________________ Terminal Leave

    6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


    1 day
    ________________________________________ Not Requested
    INCLUSIVE DATES P Requested
    February 16, 2023
    ________________________________________ ___________________ 5407193
    (Signature of Applicant) Employee No.

    7. DETAILS OF ACTION ON APPLICATION


    7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
    As of _______________________ P For approval
    Vacation Leave Sick Leave For disapproval due to ________________________
    Total Earned
    Less this application PERLA E. DELA CRUZ
    Balance School Principal II

    VICTORIA O. MADRIGAL TERESITA B. ALQUIZA, PhD.


    Administrative Officer IV (HRMO) District Supervisor

    7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:


    _______ days with pay _______________________________________
    _______ days without pay ___________________________________________
    _______ others (Specify) ___________________________________________

    ZENIA
    CECILIA G. MOSTOLES,PhD.
    E. VALDERAMA, EdD, CESO V
    Schools
    Assistant Schools Division
    Division Superintendent
    Superintendent
    Schools Division of Bulacan
    Civil Service Form No. 6
    Revised 2020

    Republic of the Philippines


    DEPARTMENT OF EDUCATION Stamp of Date of Receipt
    SCHOOLS DIVISION OF BULACAN

    APPLICATION FOR LEAVE


    1. OFFICE/DEPARTMENT 2. NAME : (Last) (First) (Middle)
    (ELEMENTARY) DEPED PANDI NORTH LOZADA DAISY MAE ANN P.

    March 7, 2023 Teacher I 27,284 .00


    3. DATE OF FILING _________________ 4. POSITION _____________________________ 5. SALARY _______________

    6. DETAILS OF APPLICATION
    6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

    Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

    Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________

    P Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) _____________________________
    Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
    Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) _____________________
    Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) P Out Patient (Specify Illness) ____________________
    Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) _____________________________________________
    Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
    10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) ________________________________
    Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) _____________________________________________
    Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
    Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
    Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
    Other purpose:
    Others: Monetization of Leave Credits
    _____________________________________ Terminal Leave

    6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


    1 day
    ________________________________________ Not Requested
    INCLUSIVE DATES P Requested
    March 6, 2023
    ________________________________________ ___________________ 5382563
    (Signature of Applicant) Employee No.

    7. DETAILS OF ACTION ON APPLICATION


    7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
    As of _______________________ P For approval
    Vacation Leave Sick Leave For disapproval due to ________________________
    Total Earned
    Less this application PERLA E. DELA CRUZ
    Balance School Principal II

    VICTORIA O. MADRIGAL TERESITA B. ALQUIZA, PhD.


    Administrative Officer IV (HRMO) District Supervisor

    7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:


    _______ days with pay _______________________________________
    _______ days without pay ___________________________________________
    _______ others (Specify) ___________________________________________

    ZUREX T. BACAY, PhD


    Assistant Schools Division Superintendent
    Civil Service Form No. 6
    Revised 2020

    Republic of the Philippines


    DEPARTMENT OF EDUCATION Stamp of Date of Receipt
    SCHOOLS DIVISION OF BULACAN

    APPLICATION FOR LEAVE


    1. OFFICE/DEPARTMENT 2. NAME : (Last) (First) (Middle)
    (ELEMENTARY) DEPED PANDI NORTH ALEX ROSBEL M.

    March 14, 2023 Teacher I 27,573 .00


    3. DATE OF FILING _________________ 4. POSITION _____________________________ 5. SALARY _______________

    6. DETAILS OF APPLICATION
    6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

    Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

    Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________

    P Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) _____________________________
    Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
    Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) _____________________
    Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) P Out Patient (Specify Illness) ____________________
    Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) _____________________________________________
    Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
    10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) ________________________________
    Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) _____________________________________________
    Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
    Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
    Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
    Other purpose:
    Others: Monetization of Leave Credits
    _____________________________________ Terminal Leave

    6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


    1 day
    ________________________________________ Not Requested
    INCLUSIVE DATES P Requested
    March 13, 2023
    ________________________________________ ___________________ 5373702
    (Signature of Applicant) Employee No.

    7. DETAILS OF ACTION ON APPLICATION


    7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
    As of _______________________ P For approval
    Vacation Leave Sick Leave For disapproval due to ________________________
    Total Earned
    Less this application PERLA E. DELA CRUZ
    Balance School Principal II

    VICTORIA O. MADRIGAL TERESITA B. ALQUIZA, PhD.


    Administrative Officer IV (HRMO) District Supervisor

    7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:


    _______ days with pay _______________________________________
    _______ days without pay ___________________________________________
    _______ others (Specify) ___________________________________________

    ROWENA T. QUIAMBAO, CESO VI


    Assistant ZENIA
    SchoolsG. MOSTOLES,
    Division EdD, CESO V
    Superintendent
    Schools Division Superintendent
    Officer-In-Charge
    Schools
    Office of the Schools Division
    Division of Bulacan
    Superintendent
    APPLICATION FOR LEAVE
    1. (ELEMENTARY) PANDI NORTH DISTRICT

    2. CHANGE (Last Name, First Name,MI)

    3. Change Date of Filling

    4. Change Position (ex. Teacher I)

    5. Change Salary ( ex. 25, 439.00)

    6. DETAILS OF APPLICATION

    6.A - Put a check on the Type of Leave to be availed of

    6.B - Put check on the Details of leave

    6.C - Change number of working days applied for ( ex. 1day) ; change inclusive date of leave

    6.D - Commutation

    Check "Requested"

    Put signature and change employee number

    7. DETAILS OF ACTION ON APPLICATION

    7.A - Certification of Leave Credits

    c/o Division Office


    7.B - Recommendation

    Put check "For Approval"

    Signatory School Principal & PSDS

    7.C - and 7.D c/o Division Office

    Signatory 30days above SDS - Zenia G.Mostoles, EdD, CESO V

    30days below ASDS- Rowena T. Quiambao, CESE

    ****NOTE Change into black font color before printing the form.

    SICK LEAVE - 4copies

    1. Form 6

    2. (5 days above) Medical Certificate bears complete details of the physician

    MATERNITY LEAVE- 4 copies

    1. Form 6

    2. Medical Certificate bears complete details of the physician

    3. CSC Form 7- Clearance

    ***File 2 weeks before the said due date.

    PATERNITY LEAVE - 4copies

    1. Form 6

    2. Marriage Contract

    3. Birthcert of the child

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