Updated Leave Requirements as of March 17, 2024

Each requirement for any type of leave should be filled in one copy

For Maternity Leave (live birth or miscarriage)

1. Letter of Intent
2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. CSC Form 41 or Medical Certificate with one documentary stamp
4. Teacher's clearance signed in full by all parties involved
5. Photocopy of Solo Parent ID (if applicable)
6. CSC Form 6a revised 2020 – Notice of Allocation for Maternity Leave (if applicable)
7. Marriage Contract for Allocation of Maternity Leave (if applicable)

For Magna Carta for Women RA 9710 (minor or major surgery caused by Gynecological
Disorders)

1. Letter of Intent
2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. CSC Form 41 or a medical certificate bearing a single documentary stamp that specifies the
number of days needed for recuperation
4. Teacher’s Clearance signed in full by all parties involved

For Sick Leave 20 days and above

1. Letter of Intent
2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. CSC Form 41 or a medical certificate bearing a single documentary stamp that specifies the
number of days needed for recuperation
4. Teacher’s Clearance signed in full by all parties involved
5. A photocopy of the most recent leave record, exclusive to teachers

For Vacation Leave/Personal Leave/Terminal Leave of Absence or Exhaustion of Service

Credits for Teachers

1. Approved (SDS) Letter of Intent

2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. CSC Clearance - The head of the office, who appears in the upper portion of the form, and
the immediate supervisor must sign the CSC clearance.
4. Division Clearance signed in full by all parties involved
5. Teacher’s Clearance signed in full by all parties involved
6. Certificate of no pending case
7. Affidavit of undertaking for loans and designation of the person(s) who will assume your
obligations within the school
8. GSIS Statement of Account
9. For Terminal Leave of Absence or Exhaustion of Service Credits – Submit Updated Record of Leave
signed by the Administrative Officer II, exclusive to teachers
 Updated Leave Requirements as of March 17, 2024
Each requirement for any type of leave should be filled in one copy

For Rehabilitation Leave (injuries sustained while in the performance of official duties)

1. Letter of Intent
2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. CSC Form 41 or a medical certificate bearing a single documentary stamp that specifies the
number of days needed for recuperation.
4. Police Report
5. Incident Report, signed by the principal of the school
6. Approved travel Order or Memorandum
7. Teacher’s Clearance in full by all parties involved

For Study Leave

1. Letter of Intent
2. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated
3. Approved Dep Ed Memorandum
4. Oath of Understanding
5. CSC Clearance - The head of the office, who appears in the upper portion of the form, and
the immediate supervisor must sign the CSC clearance.
6. Division Clearance signed in full by all parties involved
7. Teacher’s Clearance signed in full by all parties involved
8. Certification of no pending case
9. Scholarship Agreement
10. Affidavit of undertaking for loans and designation of the person(s) who will assume your
obligations within the school
11. GSIS Statement of Account

For Reinstatement
Reinstated from Sick Leave, Magna Carta for Women, Rehabilitation and Maternity Leave
1. Letter of Intent
2. CSC Form No. 211, or a medical certificate with one documentary stamp and comments that
it is fit for work
Reinstated from Vacation or Personal Leave and Travel Abroad
1. Letter of Intent
2. Approved Special Order

Reinstated from Study Leave

1. Letter of Intent
2. Transcripts of Records
Change status
1 Letter of Intent
2 PSA Marriage Certificate
3 BIR 1905 with stamp (change of status)
4 Pag-ibig MDF (change of status)
5 Philhealth MDR (change of status)

Requirements for Service Credits and Compensatory Time off (CTO)

1. Transmittal (listing the School, District, Name of Activity, Date and Venue)
2. Memorandum for Legal Basis
3. Daily Time Record
4. Accomplishment Report
 For Terminal Leave (conversion of service credits to monetary value)

Note that all requirements must be fulfilled in two original copies and one photocopy that has
been certified as true from the original and signed by the immediate head, all contained in one
folder.

1. Original Approved (SDS) Letter of Retirement

2. Original duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and
immediate head
3. Original Record of Leave - The head of the school and the person in charge of leave shall
sign the original Employees Card or Record of Leave if it applies only to teachers.
4. Original Latest Notice of Salary Adjustment (NOSA)
5. Certified True Copy GSIS Adjudication/Gratuity
6. Certified True Copy GSIS Clearance/Voucher
7. Original GSIS Application Form for Retirement – It is required that the retiree fill out the
original GSIS Application Form for Retirement.
8. Original Updated Service Record – The original updated service record and the NOSA's
salary grade must match.
9. Original Certification as to Money/Property Accountability
10. Original Special Order of Retirement
11. Original Declaration of pending/no-pending case
12. Original Certificate of Last Payment
13. Original Statement of Assets, Liabilities, and Net Worth (SALN)
14. Original Certificate of Last Day of Service (Worksheet or Form 7 is not acceptable)
15. Original Division Clearance signed in full by all parties involved
16. Original CSC Clearance - The head of the office, who appears in the upper portion of the
form, and the immediate supervisor must sign the CSC clearance.
17. Original Applicant’s Authorization in Affidavit form to deduct all financial obligations with the
employer-related payments.
18. Original Ombudsman Clearance
19. Original PSA death and marriage certificates in the event of the retiree's passing.
20. Original Extra Judicial Settlement Affidavit, notarized, in case of death

A guide for meeting the aforementioned requirements

Requirements Number Person in-charge

1,2,13,17,18,19,20 Retiree or applicant
3 District or School Leave in charge
4,9,10,12,15,16 Division HR – Personnel – Mr. Daniel
8 Division HR – Personnel – Mr. George
5,6,7 GSIS Satellite Office – Malaybalay
11 Division Legal Unit
14 District Payroll Master or Administrative Officer II in-charge
 Updated Leave Requirements as of March 17, 2024
Each requirement for any type of leave should be filled in one copy

Travel Abroad Regional Memorandum No. 135 s. 2023

1. Annex D – Travel Authority for Foreign Travel – downloadable

http://tinyurl.com/authorizedsignatories2024
2. Approved (SDS) Letter of intent stating the purpose of travelling abroad.
3. Duly accomplished and signed CSC Form 6 Revised 2020 by the applicant and immediate
head, with the service credits balance stated.
4. Teacher’s Clearance signed in full by all parties involved.
5. Division Clearance signed in full by all parties involved.
6. CSC Clearance - The head of the office, who appears in the upper portion of the form, and
the immediate supervisor must sign the CSC clearance.
7. Certificate of no pending case to be attest by the Division Legal
8. Affidavit of undertaking for loans and designation of the person(s) who will assume your
obligations within the school.
9. Certification as to who will handle the assignments of the said employee while the employee
is on leave, to be certified by the Schools Division Superintendent.
10. GSIS Statement of Account
11. Teaching Loads and Class Schedule duly signed by the applicant, substitute teacher, school
head and Schools’ Division Superintendent.
 CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that in the absence of Mr./Ms.

while he/she is on travel abroad from to
at his/her assignments shall be handled by the following
employee/s.

ASSIGNMENT/TASK ALTERNATE/SUBSTITUTE CONFORMED

(alternate/substitute
must affix signature
here)

This is to ensure that classes and/or the operations of this Division are not
hampered during the travel of the above-name employee.
This certification is issued to support the employee’s request for authority to
travel abroad.
Issued this day of at .

VICTORIA V. GAZO
Schools Division Superintendent

Address: Fortich St., Sumpong, Malaybalay City, Bukidnon

Hotline Number: +639178423657
Email Address: bukidnon@deped.gov.ph
Website: https://bukidnon.deped.gov.ph