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Leave Form

This leave form documents an employee's request for leave. It collects information such as the employee's name, position, type of leave requested, number of days, and certification of leave credits. The form is then signed by the employee and includes spaces for recommendation, approval or disapproval, and signatures from the authorized official and barangay secretary.

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Barangay Cato
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230 views2 pages

Leave Form

This leave form documents an employee's request for leave. It collects information such as the employee's name, position, type of leave requested, number of days, and certification of leave credits. The form is then signed by the employee and includes spaces for recommendation, approval or disapproval, and signatures from the authorized official and barangay secretary.

Uploaded by

Barangay Cato
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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LEAVE FORM

1. OFFICE/AGENCY 2. LAST NAME FIRST NAME MIDDLE INITIAL

_______________ _____________________ ________________ _____________

3. DATE OF FILING 4. POSITION 5. SALARY/MONTH

__________________ _________________
___________________________

6. (a) TYPE OF LEAVE 6. (b) WHERE LEAVE WILL BE ABSENT


____ VACATION 1. IN CASE OF VACATION LEAVE
____ SICK WITHIN THE PHLIPPINES
____ OTHERS (SPECIFY) _________________
____ MATERNITY 2. ABROAD: _____________

6. (c) NUMBER OF WORKING DAYS 2. (d) COMMUTATION

APPLIED FOR: ____________ ______ REQUESTED


INCLUSIVE DATES: ________ ______ NOT REQUESTED

_______________________
SIGNATURE OF APPLICANT

DETAILS OF ACTION OF APPLICATION


7. (a) CERTIFICATION OF LEAVE CREDITS 7. (b) RECOMMENDATION
AS OF _____________________ ____ APPROVAL
VACATION SICK TOTAL ____ DISAPPROVAL DUE TO:
________ ____ ______ ________________________
DAYS DAYS DAYS ________________________
____ ____ ____ ________________________

____ _EDITHA T. MABAZZA_________ ________________________


Barangay Secretary Authorized Official

7. (c) APPROVED: 7. (d) DISAPPROVED TO:


_____ DAY(S) WITH PAY __________________
_____ DAY(S) WITHOUT PAY
______ OTHERS (PLEASE SPECIFY)

ELBERT O. BALIGOD
Punong Barangay

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