Republic of the Philippines

NATIONAL ECONOMIC AND DEVELOPMENT AUTHORITY

Region V, Arimbay, Legazpi City

APPLICATION FOR LEAVE

1. STAFF/DIVISION 3. NAME (Last) (First) (M.I.)

FAD SALA ARCADIO O
2. DATE OF FILING 4. POSITION 5. SALARY (Monthly)
January 5, 2021 Administrative Assistant II 16,903.00
DETAILS OF APPLICATION
6 A. TYPE OF LEAVE C. WHERE LEAVE WILL BE SPENT
Vacation 1 IN CASE OF VACATION LEAVE
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2 IN CASE OF SICK LEAVE

Maternity In Hospital (Specify)
X Others (Specify) Welfare Leave
Time-off Out Patient (Specify)

B NUMBER OF WORKING DAYS APPLIED FOR D. COMMUTATION

1 day Requested Not Requested
Inclusive date/s January 12, 2021

(Signature of Applicant)
DETAILS OF ACTIONS ON APPLICATION
A CERTIFICATION OF LEAVE CREDITS B. RECOMMENDATIONS
As of
Vacation Sick Total
Days Approval
CERTIFICATION OF SPECIAL LEAVE BENEFITS BALANCE Disapproval due to
As of
of THREE DAYS

CERTICATION OF OVERTIME CREDITS

As of EDNA CYNTHIA BERCES
Hours Minutes (Authorized Official)

(HRMO)
C. APPROVED FOR D. DISAPPROVED DUE TO:

days with pay

days without pay
Others (Specify)

APPROVED BY:

AGNES E. TOLENTINO, CESO III

Regional Director

NRO5-F-HR-33 Rev. 0 May 15, 2014