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Leave Form BLANK

The document is an application for leave from an employee of the Department of Foreign Affairs. It collects information such as the applicant's name, rank, type of leave being requested, dates, and requires certification of leave credits and recommendation/approval. The application form provides instructions on applying for different types of leave like vacation, sick, or maternity leave.

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18 views

Leave Form BLANK

The document is an application for leave from an employee of the Department of Foreign Affairs. It collects information such as the applicant's name, rank, type of leave being requested, dates, and requires certification of leave credits and recommendation/approval. The application form provides instructions on applying for different types of leave like vacation, sick, or maternity leave.

Uploaded by

ankarape
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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DEPARTMENT OF FOREIGN AFFAIRS

APPLICATION FOR LEAVE


Civil Service Form
1. OFFICE/AGENCY 2. NAME (last) (first) (middle)
ANKARA PE HERNANDEZ RAUL SALAVARIA
2. DATE OF FILING 3. RANK 5. SALARY (monthly)
21 JANUARY 2020 CM I
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  Out patient
__________________ ___________________________________________
6. C. NO. OF WORKING DAYS APPLIED FOR 6. D. COMMUTATIONS
___4 days_______________________  Requested  Not Requested
INCLUSIVE DATES
__15 Feb to 01 March 2020_________ __________________________________
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 __________________
___________________________________
Days Days Days

Certified by: __________________________ RAUL S. HERNANDEZ


Ambassador

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


_______________ Days with pay __________________________________________________
_______________ Days without pay
_______________ Others (Specify) __________________________________________________

_______________________________
(SIGNATURE)

_______________________________
(CERTIFIED OFFICIAL)
DATE: ________________

1. Application for vacation or sick leave for one full day or more shall be made on this form in duplicate.
2. Application for vacation leave should be filed in advance whenever possible five (5) days before going on such leave.
3. Application for vacation leave exceeding thirty (30) calendar days and leave to be spent abroad, regardless of the number of days should be accompanied by
duly accomplished DFA clearance.
4. Application for sick leave applied in advance or exceeding five (5) days shall be accompanied by a medical certificate.
5. Application for maternity should always be in sixty (60) days or two (2) months regardless if with full pay or without pay or with half pay shall be
accompanied by a medical certificate and duly accomplished DFA clearance.

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