Scribd
Upload
13 views1 page

Leave Form CS Form No. 6

Uploaded by

antonio ramos
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
13 views1 page

Leave Form CS Form No. 6

Uploaded by

antonio ramos
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
You are on page 1/ 1

Civil Service Form No.

6
Revised 2020
Vacation Leave Sick Leave ANNEX A
Total Earned
Less this application
Balance Republic of the Philippines
Department of Education
Region
Division

APPLICATION FOR LEAVE


1. OFFICE/DEPARTMENT 2. NAME: (Last) (First) (Middle)

3. DATE OF FILING, ____________ 4. POSITION 5. SALARY __________________

6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Mandatory/Forced In case of Vacation/Special Privilege Leave:
Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Sick Leave (Sec. 43, Rule XVI, Within the Philippines
Omnibus Rules Implementing E.O. No. 292) Abroad (Specify)
Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS)
In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended)
In Hospital (Specify Illness)
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Out Patient (Specify Illness)
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004)
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
In case of Special Leave Benefits for Women:
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005)
(Specify Illness)
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Special
Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) Special Emergency
In case of Study Leave:
(Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Adoption Leave (R.A. No. 8552)
Completion of Master's Degree
BAR/Board Examination Review
Others:
Other purpose:
Monetization of Leave Credits
Terminal Leave
6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION
Not Requested
Requested
INCLUSIVE DATES (____________________)
(Signature of Applicant)

7. DETAILS OF ACTION ON APPLICATION


7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
As of For approval
For disapproval due to

(Authorized Officer)
(Authorized Officer)

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


days with pay
days without pay
others (Specify)

_________________________
(Authorized Officer)

You might also like