You are on page 1of 4

APPLICATION FOR LEAVE

1. OFFICE/ AGENCY 2. NAME(LAST) (FIRST) (MIDDLE)


Calantac Elementary School
Alcala East District
3. DATE OF FILING 4. POSITION 5. MONTHLY SALARY

DETAILS OF APPLICANT

6.a) TYPE OF LEAVE 6.b) WHERE LEAVE BE SPENT


( ) Vacation
c) IN CASE OF VACATION LEAVE
( ) To seek employment ( ) Within the Philippines
( ) Others (specify)_____________ ( ) Abroad (specify)________________________________________
MANDATORY LEAVE/FORCE ____________________________________________________________
LEAVE ( ) In case of sick leave
( ) In hospital (specify)____________________________________
( ) sick ( ) Out patient (specify)___________________________________
( ) Maternity _____________________________________________________________

d. COMMUTATION
( ) Requested ( ) Not Requested
e) NO. OF WORKING DAYS APPLIED FOR
DAYS
Inclusive Dates: _____________________
Signature of Applicant

DETAILS OF APPLICATION

7.a) CERT. OF LEAVE CREDITS 7.b) RECOMMENDATION


As of Date______________________
VAC. SICK TOTAL ( ) Approved
Unused: ___________ _____________ ____________ ( ) Disapproved due to __________________________________
_________________________________________________________
This Leave:_________ _________ _________
_________________________________________________________
Balance: _________ _________ ________
ROSAURO C. BELEN
__________________________ HRMO/Administrative Officer I
Personnel Officer
7.c) APPROVED FOR: 7.d) DISAPPROVED DUE TO:
____________________Days with pay _________________________________________________
____________________Days without pay
____________________Others (specify
_________________________________________________

LEILA PIÑERA AREOLA,Ph.D., CESO VI


Schools Division Superintendent

Date: ___________________________

INSTRUCTIONS
1. Application for vacation or sick leave for one full day or more shall be made on this form and to be
accomplished n 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 shall be filed in advance, a medical cert. shall accompany exceeding five (5) days. In
case of medical consultation was not availed, the applicant should execute an affidavit.
4. An employee who is absent without approved leave shall not be entitled to receive his/her salary
corresponding to the period of his/her unauthorized leave of absence.
5. An application for leave of absence for thirty (30) days or more shall be accompanied by clearance from
money, property accountabilities.
APPLICATION FOR LEAVE
5. OFFICE/ AGENCY 6. NAME(LAST) (FIRST) (MIDDLE)
Tupang Elementary School BUENO GLORIA TORRADO
Alcala East District
7. DATE OF FILING 8. POSITION 5. MONTHLY SALARY
MAY 7,2018
P II 47,742.00
DETAILS OF APPLICANT

6.a) TYPE OF LEAVE 6.b) WHERE LEAVE BE SPENT


( ) Vacation
c) IN CASE OF VACATION LEAVE
( ) To seek employment ( ) Within the Philippines
( ) Others (specify)_____________ ( ) Abroad (specify)________________________________________
MANDATORY LEAVE/FORCE ____________________________________________________________
LEAVE ( ) In case of sick leave
( ) In hospital (specify)____________________________________
( ) sick ( ) Out patient (specify)___________________________________
( ) Maternity _____________________________________________________________

d. COMMUTATION
( ) Requested ( ) Not Requested
e) NO. OF WORKING DAYS APPLIED FOR
2 DAYS
Inclusive Dates: MAY 15 TO MAY 16,2018 GLORIA T. BUENO
Signature of Applicant

DETAILS OF APPLICATION

7.a) CERT. OF LEAVE CREDITS 7.b) RECOMMENDATION


As of Date______________________
VAC. SICK TOTAL ( ) Approved
Unused: ___________ _____________ ____________ ( ) Disapproved due to __________________________________
_________________________________________________________
This Leave:_________ _________ _________
_________________________________________________________
Balance: _________ _________ ________
ROSAURO C. BELEN
__________________________ HRMO/ Administrative Officer I
Personnel Officer
7.c) APPROVED FOR: 7.d) DISAPPROVED DUE TO:
____________________Days with pay _________________________________________________
____________________Days without pay
____________________Others (specify
_________________________________________________

LEILA PIÑERA AREOLA,Ph.D., CESO VI


Schools Division Superintendent

Date: ___________________________

INSTRUCTIONS
6. Application for vacation or sick leave for one full day or more shall be made on this form and to be
accomplished n duplicate.
7. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on
such leave.
8. Application for sick leave shall be filed in advance, a medical cert. shall accompany exceeding five (5) days.
In case of medical consultation was not availed, the applicant should execute an affidavit.
9. An employee who is absent without approved leave shall not be entitled to receive his/her salary
corresponding to the period of his/her unauthorized leave of absence.
10. An application for leave of absence for thirty (30) days or more shall be accompanied by clearance from
money, property accountabilities.
APPLICATION FOR LEAVE
9. OFFICE/ AGENCY 10. NAME(LAST) (FIRST) (MIDDLE)
Baybayog Elementary School BELTRAN VERONICA CENTENO
Alcala East District
11. DATE OF FILING 12. POSITION 5. MONTHLY SALARY
SEPT,.03,2018
P II 47,742.00
DETAILS OF APPLICANT

6.a) TYPE OF LEAVE 6.b) WHERE LEAVE BE SPENT


( ) Vacation
c) IN CASE OF VACATION LEAVE
( ) To seek employment ( ) Within the Philippines
( ) Others (specify) ( ) Abroad (specify)________________________________________
MANDATORY LEAVE/FORCE LEAVE ____________________________________________________________
( ) sick ( ) In case of sick leave
( ) In hospital (specify)____________________________________
( ) Maternity ( ) Out patient (specify)___________________________________
_____________________________________________________________

e) NO. OF WORKING DAYS APPLIED FOR d. COMMUTATION


( ) Requested ( ) Not Requested
3 DAYS
Inclusive Dates: SEPT. 10 TO SEPT. 12, 2018
VERONICA C. BELTRAN
Signature of Applicant

DETAILS OF APPLICATION

7.a) CERT. OF LEAVE CREDITS 7.b) RECOMMENDATION


As of Date______________________
VAC. SICK TOTAL ( ) Approved
Unused: ___________ _____________ ____________ ( ) Disapproved due to __________________________________
_________________________________________________________
This Leave:_________ _________ _________
_________________________________________________________
Balance: _________ _________ ________
ROSAURO C. BELEN
__________________________ HRMO/ Administrative Officer I
Personnel Officer
7.c) APPROVED FOR: 7.d) DISAPPROVED DUE TO:
____________________Days with pay _________________________________________________
____________________Days without pay
____________________Others (specify
_________________________________________________

LEILA PIÑERA AREOLA,Ph.D,CESO VI


Schools Division Superintendent

Date: ___________________________

INSTRUCTIONS
11. Application for vacation or sick leave for one full day or more shall be made on this form and to be
accomplished n duplicate.
12. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going on
such leave.
13. Application for sick leave shall be filed in advance, a medical cert. shall accompany exceeding five (5) days.
In case of medical consultation was not availed, the applicant should execute an affidavit.
14. An employee who is absent without approved leave shall not be entitled to receive his/her salary
corresponding to the period of his/her unauthorized leave of absence.
15. An application for leave of absence for thirty (30) days or more shall be accompanied by clearance from
money, property accountabilities.

You might also like