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Blank Leave Form2

This document is an application for leave form containing fields for the applicant's name, signature, position, salary, office, date of filing, number of working days applied for, inclusive dates, and type of leave requested. The form also includes sections for recommending and approving officials to take action on the application, and tracks the applicant's leave credits and balances.

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Dominic Embodo
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94 views1 page

Blank Leave Form2

This document is an application for leave form containing fields for the applicant's name, signature, position, salary, office, date of filing, number of working days applied for, inclusive dates, and type of leave requested. The form also includes sections for recommending and approving officials to take action on the application, and tracks the applicant's leave credits and balances.

Uploaded by

Dominic Embodo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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CSC FORM NO.

6 (1985) APPLICATION FOR LEAVE

Name: __________________________________ Vacation Special Leave


Signature: _______________________________
Position: ________________________________ Within the Philippines Abroad
Monthly Salary: Php ______________________
Office/Division: __________________________ Sick Out Patient ( Specify )
Date of Filing: ___________________________
No. of Working Days Applied for: ___________ In Hospital ( Specify )
Inclusive Dates: __________________________
__________________________ Terminal Leave
Commutation ____________________________
ACTION ON APPLICATION
/ Requested Recommending:

FOR PERSONNEL USE ONLY: Approval

Disapproval due to ______________


Leave credits V.L. S.L. TOTAL
As of ________ ______ ______ _______
Enjoyed Leave ______ ______ _______ ____________________________________
TOTAL ______ ______ _______ HEAD OF OFFICE
Less, this Leave ______ ______ _______
Balance ______ ______ _______
______ ______ _______ Approved for: Disapproved
_________ days with pay due to ________
CERTIFIED CORRECT: _________ days w/o pay _____________

ELINA A. VIVAS Date: ____________ ELMER L. JAVELONA


Admin. Officer, III Municipal Mayor

CSC FORM NO. 6 (1985) APPLICATION FOR LEAVE

Name: __________________________________ Vacation Special Leave


Signature: _______________________________
Position: ________________________________ Within the Philippines Abroad
Monthly Salary: Php ______________________
Office/Division: __________________________ Sick Out Patient ( Specify )
Date of Filing: ___________________________
No. of Working Days Applied for: ___________ In Hospital ( Specify )
Inclusive Dates: __________________________
__________________________ Terminal Leave
Commutation ____________________________
ACTION ON APPLICATION
/ Requested Recommending:

FOR PERSONNEL USE ONLY: Approval

Disapproval due to ______________


Leave credits V.L. S.L. TOTAL
As of ________ ______ ______ _______
Enjoyed Leave ______ ______ _______ ____________________________________
TOTAL ______ ______ _______ HEAD OF OFFICE
Less, this Leave ______ ______ _______
Balance ______ ______ _______
______ ______ _______ Approved for: Disapproved
_________ days with pay due to ________
CERTIFIED CORRECT: _________ days w/o pay _____________

ELINA A. VIVAS Date: ____________ ELMER L. JAVELONA


Admin. Officer, III Municipal Mayor

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