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CSC Form 6 2017

This document is an application for leave form from the Department of Education Division of Bukidnon. It collects information such as the applicant's name, employee ID number, position, monthly salary, type of leave being requested, inclusive dates of the requested leave, and places for certification of leave credits as well as approval or disapproval of the application. The form notes that application for vacation or sick leave of one day or more must be filed using this form, and that vacation leave applications must be submitted in advance while sick leave requests of 5 days or more require a medical certificate.

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Jessan Neri
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95 views1 page

CSC Form 6 2017

This document is an application for leave form from the Department of Education Division of Bukidnon. It collects information such as the applicant's name, employee ID number, position, monthly salary, type of leave being requested, inclusive dates of the requested leave, and places for certification of leave credits as well as approval or disapproval of the application. The form notes that application for vacation or sick leave of one day or more must be filed using this form, and that vacation leave applications must be submitted in advance while sick leave requests of 5 days or more require a medical certificate.

Uploaded by

Jessan Neri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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DEPARTMENT OF EDUCATION

Region X - Northern Mindanao


DIVISION OF BUKIDNON
Fortich Street, Sumpong, Malaybalay City
www.depedbukidnon.net.ph
APPLICATION FOR LEAVE
CSC Form 6
(Revised 2015)
1. Office/Agency Employee ID/Number:
DepED - Division of Bukidnon School/Office:
District:
Employee Contact Number:

2. Name:
(Last Name) (First Name) (Middle Name)

3. Date of Filing: 4. Position:


5. Monthly Salary:

6. a. Type of Leave 6.b. Where leave will be spent in case of Vacation Leave?
Vacation Leave
To seek employment
Forced Leave
Sick Leave In case of Sick Leave, please specify the place of recovery.
Maternity Leave
Others (Please specify)

Commutation Requested
7. Number of working days applied: Not Requested
Inclusive dates: 9/22/2017

(Signature over Printed Name of Employee)

(Signature over Printed Name of Immediate Head)

DETAILS OF ACTION ON APPLICATION


7. A. Certification of Leave Credits 7. B. Recommendation
Vacation Leave
Credits Sick Leave Credits Total Leave Credits Vacation Leave Credits Sick Leave Credits Total Leave Credits

KATHLEEN ANN T. DUMAS


Administrative Officer V
7. C. APPROVED FOR: 7. D. DISAPPROVED due to:

days with pay

days without pay

JESNAR DEMS S. TORRES. Ph. D.


OIC - Schools Division Superintendent
1. Application for vacation or sick leave for one full day or more shall be made on this form and to be accomplished in four copies.
2. Application for vacation leave shall be filed in advance. In case of sick leave five days and above shall be accompanied with medical certificate.
3. An employee who is absent without approved leave shall not be entitled to receive his salary corresponding the period his authorized leave of absence.

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