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Applctn 4 Leave

Jesslyn G. Gavino, a teacher at the Division of Surigao City District V, applied for two days of sick leave from September 5-6, 2013. As a teacher, she earns a monthly salary of PHP18,549. The application was approved by the administrative officer.

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25 views

Applctn 4 Leave

Jesslyn G. Gavino, a teacher at the Division of Surigao City District V, applied for two days of sick leave from September 5-6, 2013. As a teacher, she earns a monthly salary of PHP18,549. The application was approved by the administrative officer.

Uploaded by

jess_gavino
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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CSC Form No.

6 Revised 2000

APPLICATION FOR LEAVE


1. OFFICE/AGENCY 2. NAME (Last) (First) (Middle)

DIVISION OF SURIGAO CITY DISTRICT V


3. DATE OF FILING

GAVINO,

JESSLYN

MAYLON

4. POSITION

5. SALARY (Monthly)

SEPTEMBER 13, 2013


6.a) TYPE OF LEAVE _____ Vacation _____ To seek employment _____ Others Specify _________________ __X___ Sick _____ Maternity _____ Others Specify _________________ 6.c) NUMBER OF WORKING DAYS APPLIED FOR: TWO (2) daySs Inclusive Dates

TEACHER I DETAILS OF APPLICATION

PHP18, 549.00

6.b) WHERE LEAVE WILL BE SPENT: (1) IN CASE OF VACATION LEAVE _____ Within the Philippines _____ Abroad (Specify) ____________________ (2) IN CASE OF SICK LEAVE ____ In Hospital (Specify) _________________ d) COMMUTATION _____ Requested

_____ Not Requested

JESSLYN M. GAVINO
Signature of Applicant

SEPTEMBER 5-6, 2013 DETAILS OF ACTION ON APPLICATION


7.a) CERTIFICATION ON LEAVE CREDITS As of _____________ Vacation Days Sick Days Total Days __________________________________ Authorized Official 7. d) RECOMMENDATION _______ Approved _______ Disapproved due to ______________________________ ______________________________ (Signature) ______________________________ (Authorized Official) DATE: ____________ 1. Application for vacation/ sick leave for one full day or more shall be made on this form and to be accomplished at least in duplicate. 2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on such leave. 3. Application for sick leave filed in advance, or exceeding five (5) days shall be accompanied by a medical certificate. In case medical certificate is not available, an affidavit of absence shall be executed. 7.b) RECOMMENDATION [ ] Approved [ ] Disapproved due to _____________________

GEMMA P. SINDAY Administrative Officer V


7. c) APPROVED FOR ____ days with pay ____ days without pay

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