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Form 6. Leave Form Revised 2020-1-1

This document is an application for leave submitted by Eileen M. Balila, an ADAS-II at the Department of Education - Schools Division of Koronadal City. She is applying for 2 days of CTO to attend a COC. The application provides details of the applicant's position and leave request. It also includes sections for certifying leave credits, recommending approval or disapproval, and the final approval or disapproval by the Schools Division Superintendent.

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Kimberly Villanueva
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63 views1 page

Form 6. Leave Form Revised 2020-1-1

This document is an application for leave submitted by Eileen M. Balila, an ADAS-II at the Department of Education - Schools Division of Koronadal City. She is applying for 2 days of CTO to attend a COC. The application provides details of the applicant's position and leave request. It also includes sections for certifying leave credits, recommending approval or disapproval, and the final approval or disapproval by the Schools Division Superintendent.

Uploaded by

Kimberly Villanueva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Civil Service Form No.

6 ANNEX A
Revised 2020
Republic of the Philippines
STAMP OF DATE RECEIVED
Department of Education - Schools Division of Koronadal City
Jaycee Ave. Corner Rizal St., Brgy. Zone IV, Koronadal City, South Cotabato

APPLICATION FOR LEAVE


1. OFFICE/SCHOOL: 2. NAME: (LAST) (FIRST) (MIDDLE)
SDO KORONADAL BALILA EILEEN M.
3. DATE OF FILING: 4. POSITION: 5. SALARY: (Monthly)
ADAS-II

6. DETAILS OF APPLICATION
6. A. TYPE OF LEAVE: 6. B. DETAILS OF LEAVE:
q Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of vacation/ Special Leave:
Mandatory/ Forced Leave (Sec. 25, Rule XVI, Omnibus Rules Implementing E.O.
q No. 292) q Within the Philippines
q Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) q Abroad (Specify) _____________________
q Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS)

q Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In case of Sick Leave:
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No.
q 292) q In Hospital (Specify Illness)
q Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004)

q Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) q Out Patient (Specify Illness)
q 10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005)
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No.
q 292)
In case of Special Leave Beneifts for Women:
q Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) (Specify Illness)
q Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended)

q Adoption Leave (R.A. No. 8552 In case of Study Leave:


q OTHERS: q Completion of Master's Degree
2 days CTO TO COC q Bar/ Board Examination Review
Other purpose:
q Monetization of Leave Credits
q Termination Leave

6. C. NUMBER OF WORKING DAYS APPLIED FOR 6. D. COMMUTATION


q Not Requested
INCLUSIVE DATES q Requested

(Signature of Applicant)
7. DETAILS OF ACTION ON APPLICATION

7. A. CERTIFICATION OF LEAVE CREDITS 7. B. RECOMMENDATION


As of q For Approval
q For Disapproval due to __________________
Vacation Leave Sick Leave _____________________________________
Total Earned _____________________________________
Less this application _____________________________________
Balance

FAIZAL B. MACASAYON DANILO C. ABANIL


Administrative Officer IV/ HRMO SGOD CHIEF

7. C. APPROVED FOR: 7. D. DISAPPROVED DUE TO:

1 Day/s with pay _________________________________


_____ Day/s without pay _________________________________
_____ Others (Specify) _________________________________

CRISPIN A. SOLIVEN JR., CESE


Schools Division Superintendent
(Head of Office)

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