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    Leave Form Revised 2020

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    Leave Form Revised 2020

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    Leave form revised 2020

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    3 views2 pages

    Leave Form Revised 2020

    Uploaded by

    norciowilhelmina

    Copyright:

    © All Rights Reserved
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    (Seve Form No. 6 Revised 2020 Republic ofthe Philippines Tel, No. 703-43-82 Email: heath@auezoncity gov. ph Intp/healthquezoncity.gov.ph APPLICATION FOR LEAVE QUEZON CITY HEALTH DEPARTMENT ML, Quezon St. cor Kalayaan Ave. Diliman, Quezon City ANNEX A [7 OFFICETDEPARTMENT 2 WANE Teast) Fist Twiaiey ls. DATE OF FILING 4 Posmon DETAILS OF APPLICATION JzA_ TYPE OF LEAVE TO BE AVALED OF vacaton Leave (Sec. 5, Rule XV, Omnibus Rules implementng E.0. No. 292) Ci mandataryForced Leave (See 25, Re XV, Omnibus Rules implementing EO. No. 292) sick Leove (See 43, Re XV, Ornibus Rules implementing E 0. No. 282) i matamity Leave RA. No. 11210 IRR ised by CSC, COLE and 585) Petey Leave (RANG, 8187 / CSC MC. No.7, 8. 1998, ax amended) special Pivtege Leave (Sec. 21, Rule XV, Omabus Rules Inplementng E.0.No. 282) sole Parent Leave (RA No. 8972/ CSC MC No.8, 2004) 1 stcy Leave (Se. 68, Rule XV, Omnibus Rides Implementing E.0, No. 252) 1 toy VaWe Leave (RA No, 9282 / CSC MC No. 15,5. 2015) Letatitaton Piege (Sec. 55, Rule XVI, Omnibus Rules Implementing E 0, No. 282) special Leave Benes for Women (RA. No, 9710 /CSC MC No, 25,8. 2010) Ll specie Emergency (Calamity) Leave (CSC MC No. 25.2012, aa amended) Di) Asenton Leeve (RA No. 8852) one: [B.@ DETAILS OF LEAVE In cose of Vacation’Special Prvfege Leave [El win the Pritppines D1 Arona (Specify) Incase of Sick Leave C1 InHospital (Specity Hines) _____ Done atent (Spety ines) ‘© NUMBER OF WORKING DAYS APPLIED FOR INCLUSIVE DATES fr.A CERTINCATION OF LEAVE CREDITS: Aso Vacation Leave ‘Sick Laave. Tou Eure ase te apetcaton | FEC. AVENIDO Human Resource Mgt. Officer Il j7-© APPROVED FOR: days wih pay aye wihout pay others (spect) 7.0 DISAPPROVED DUE TO: ESPERANZA ANITA N. ESCANO-ARIAS, MD, MPH Officer-In-Charge, Quezon City Health Department INSTRUCTIONS AND REQUIREMENTS _ | Application for any type of laave shall be made on this Form and to be_accomplished_at_lenst_in duplicate with documentary recwirernente, an oiowe 1. Vacation Leave ‘+ Mahal te fed fve (5) days in advance, whenever possible, ofthe effective date of such leave. Vacation leave wathin in the Philippines oF abroad shal be indicated in the form for Purposes. of securing travel authorty and completing ‘learance from money and work accountabilities 2 MandatoryiForced Leave + Annual fve-day vacation leave shall be frfeted not taken during the year. In case the scheduled leave has been Canceled in the exigency of the service by the head of ‘agency. shall no longer be dechcted from the accumulated vacation leave Avaiment of one (1) day or more Vacation, Leave (VL) shall be considered for complying the mancatoryitorced leave subject to the condtions under Section 25, Rule XVI of the Omnibus Rules Implementing EO No 292 3 Siok Leave ‘+ It shat be fled immediately upon employee's retum from such leave + It fled in advance or exceeding five (5) days. application shall be accompanied by a medical centicate. In case ‘medical consultation was not avaied of, an affidavit should be executed by an applicant 4 Maternity Leave ~ 105 days *+ Proof of pregnancy @.g. ukrascund, doctor's certificate on the expected date of delivery + Accomplished Notice of Allocation of Matemity Leave Credits (CS Form No. 6a). if needed + Seconded female employees shail enjoy maternity leave with fll pay inthe recipient agency. 5. Paternity Leave - 7 days + Proof of child's delivery 09. bith cenifcate, medical certificate and mariage contract, 5. Special Privilege Leave ~ 3 days ‘+ It shall be fled/approved for at least one (1) week prior to avaiiment, except on emergency cases. Special privilege leave within he Philippines or abroad shall be indicated in the form for purposes of securing travel authonty and ‘completing clearance from money and work accountabilities. 7. Solo Parent Leave —7 days. ‘+ It shail be flled in advance or whenever possible five (5)

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