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New Leave Form

This document is an application for leave from a government office or agency. It collects information such as the applicant's name, position, salary, type of leave requested (vacation, sick, maternity), number of working days, inclusive dates, and whether commutation is requested. It also documents the certification of available leave credits, recommendation on approval/disapproval, number of approved/disapproved days, and signatures of authorized officials processing the application.

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PEMS Ivan Theodore P Lopez
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26 views2 pages

New Leave Form

This document is an application for leave from a government office or agency. It collects information such as the applicant's name, position, salary, type of leave requested (vacation, sick, maternity), number of working days, inclusive dates, and whether commutation is requested. It also documents the certification of available leave credits, recommendation on approval/disapproval, number of approved/disapproved days, and signatures of authorized officials processing the application.

Uploaded by

PEMS Ivan Theodore P Lopez
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 6 Revised 1998

APPLICATION FOR LEAVE


1. Office/Agency 2. Name (Last) (First) (Middle)

3. Date of Filing 4. Position 5. Salary

DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave


Maternity In hospital (Specify)
Others (Specify)
Outpatient

6. C) Number of Working Days applied for: 6. D) Commutation

Inclusive Dates: Requested Not Requested

Signature of Applicant

DETAILS OF ACTION ON APPLICATION


7. A) Certification of Leave Credits 7. B) Recommendation:
as of
Approval
Vacation Sick Total
Disapproval due to

Total

Authorized Official

Chief, Personnel Division


7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

Authorized Official

Date:

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