Republic of the Philippines

Case Management Service

System Development Division

Office of the Solicitor General

APPLICATION FOR LEAVE

CSC Form No. 6

I. PERSONAL DATA

POSITION:

VACATION
W/IN THE PHILS.

ADMIN. OFFICER II

OFFICE/DIV/UNIT/SERVICE: Ordoez Division

MONTHLY SALARY: Php 18549.00
DATE OF FILING:

LOGBOOK PAGE NO.: ________

II. TYPE OF LEAVE

NAME: MARIO G. LABASTIDA

ABROAD (Specify):

SICK
OUT PATIENT
(SPECIFY)

IN HOSPITAL

MATERNITY

LEAVE W/OUT PAY

December 22, 2014

INCLUSIVE DATES:

NO. OF WORKING
DAYS APPLIED FOR:

December 29, 2014

TERMINAL

DAY(S)

by Andy Galvez

OTHER (Specify)

Privilege

COMMUTATION

SIGNATURE

REQUESTED

III. CERTIFICATION OF LEAVE CREDITS

FOR PERSONNEL USE
ONLY

VL

NOT REQUESTED

IV. RECOMMENDATION

SL

Total
APPROVED

ACCRUED LEAVE CREDITS

AS OF

DISAPPROVED DUE TO:

LESS: THIS LEAVE

BALANCE
SS LESTER O. FIEL

Certified by:

AUTHORIZED OFFICIAL

Michael Joey S. Dacanay

DATE

Supervising Administrative Officer

V. APPROVAL
APPROVED FOR:
__________ day/s with pay
__________ day/s without pay
__________ others (specify)

DISAPPROVED DUE TO:

____________________
____________________
____________________
ASG KARL B. MIRANDA
AUTHORIZED OFFICIAL
DATE

INSTRUCTIONS
1.
Application for vacation or sick leave for one (1) full day or more shall be made on this form.
2.
Application for vacation leave shall be filed in advance, or whenever possible, five (5) days before going such leave.
3.
Application for sick leave filed in advance or exceeding five (5) days shall be accompanied by a medical certificate.
OSG Building, 134 Amorsolo St., Legaspi Village, Makati City, Philippines. 1229 * Tel. No. (632) 818-6301 to 09 * Fax No. (632) 8137552 * Website www.osg.gov.ph