ALA: ___________

Date Recd: _________

Recvd by:____________

APPLICATION FOR LEAVE

ID No. LIMSIACO JR RENATO L

Republic
Republicofofthe
thePhilippines
Philippines
1. OFFICE/ AGENCY:
PHILIPPINE
PHILIPPINE HEALTH
2. NAME
HEALTH INSURANCE
INSURANCE
(FIRST) (MI)
(LAST)
CORPORATION
CORPORATION
3. DATE OF FILING:
Human
HumanResource 4. POSITION: SIA I
ResourceDepartment
Department 5. SALARY (MONTHLY)
Rm.
Rm.1507,
1507,15th
15thFlr.
Flr.CityState
CityStateCentre
Centre709
709Shaw
ShawBoulevard,
Boulevard,Pasig
PasigCity
City
Tel.
Tel.Nos.
Nos.638-3083/637-5648/637-9999
638-3083/637-5648/637-9999loc. loc.1522,
1522,1544
1544

6.a) TYPE OF LEAVE: 6.c) WHERE LEAVE WILL BE SPENT:

Vacation Leave (1) (In case of Vacation Leave)
Sick Leavepls specify Within the Philippines
Special Privilege Leave Abroad (Specify)
Forced Leave
Maternity Leave (2) (In case of Sick Leave)
Paternity Leave In-hospital (specify)
Compensatory Leave Out-patient (specify)
Solo Parent Leave
Others: MONETIZATION 6.d) COMMUTATION:
6.b) NO. OF WORKING DAYS APPLIED Requested Not requested
Inclusive dates: 25 days vl, 25 days sl

Signature of Employee

DETAILS OF ACTION ON APPLICATION

7.a) RECOMMENDING APPROVAL: 7.b)APPROVAL:

RECOMMENDED NOT RECOMMENDED APPROVED DISAPPROVED

Pls. state reason:

WALTER R. BACAREZA EVELYN C. BANGALAN RAMON F. ARISTOZA, JR

Regional Vice President Area Head OIC-EVP & COO

*Only the authorized signatory based on the Signing and Delegation of Authority shall be indicated here- see back for refer
FOR HRD/PhRO - HR UNIT USE ONLY

8.a) CERTIFICATION OF LEAVE CREDITS 8.b) PROCESSED FOR:

31-Oct-14
No. of Days with Pay
No. of Days without Pay
VACATION SICK TOTAL Others (Specify)

69.298 108.057 177.355 8.c) HRD/PhRO HR Unit Action

EMMANUEL C. MONTILLA
HRMO III/Unit Head
Signing and Delegation of Authority (Pursuant to Office Order No. 37, s-2008)

Sick Leave/Vacation Leave/Special Privilege Leave/Paternity Leave/Solo Parent Leave

Recommending approval Approval

Third Level with SG 28 - 29 N/A President and CEO
Third Level with SG 26-27
5 days and below N/A Immediate Supervisor
6 days but not to exceed 15 daysImmediate Supervisor Sector Head
16 to 30 days Sector Head Executive Vice President/COO
31 days and above Sector Head & EVP/COO President and CEO

Rank and File

5 days and below Immediate Supervisor Immediate Third Level Superior
6 days but not to exceed 15 daysThird Level Officer Sector Head
16 to 30 days Sector Head Executive Vice President/COO
31 days and above Sector Head & EVP/COO President and CEO

Vacation Leave Abroad

3 days and below Sector Head Executive Vice President/COO

4 days & above Sector Head & EVP/COO President and CEO

Maternity Leave
3rd level officer Immediate Supervisor & President and CEO
EVP/COO
Rank and File Immediate Supervisor Immediate Third Level Superior

Study Leave/Rehabilitation LImmediate 3rd Level Superior President and CEO

and EVP/COO

Terminal Leave
Compulsory
3rd Level Officer Sector Head & EVP/COO President and CEO
Rank & File Sector Head Executive Vice President/COO

Optional
3rd Level Officer Comptrollership Dept. Head & President and CEO
Sector Head and EVP/COO
Rank and File Comptrollership Dept. Head & Executive Vice President/COO
Sector Head

Monetization of Leave Credits

Third Level with SG 28 - 29N/A President and CEO
Third Level with SG 26-27 Sector Head Executive Vice President/COO
Rank & File Third Level Superior Sector Head

Prescribed period of submission of Application for Leave of Absence (ALA) to the HRD/PhRO

Sick Leave: Within 2 working days upon return for work

Vacation Leave/Special Leave: At least 3 working days before effectivity of applied leave
Maternity Leave/Vacation Leave abroad: 1 month prior to effectivity of applied leave
 Recvd by:____________

DISAPPROVED

ation of Authority shall be indicated here- see back for reference

e Leave/Paternity Leave/Solo Parent Leave

Executive Vice President/COO

Immediate Third Level Superior

Executive Vice President/COO

Executive Vice President/COO

Immediate Third Level Superior

Executive Vice President/COO

Executive Vice President/COO

Executive Vice President/COO

for Leave of Absence (ALA) to the HRD/PhRO - HR Unit

 ALA:____________
Date Recd: _________
Recvd by:___________

APPLICATION FOR LEAVE

ID No.10068199
ANG CHARINA LUZ C
Republic
Republicof
ofthe
thePhilippines
Philippines
1. OFFICE/ AGENCY: PHRO8-FOD
PHILIPPINE
PHILIPPINE HEALTH
HEALTH2. NAME
INSURANCE
INSURANCE (FIRST) (MI)
CORPORATION
CORPORATION
(LAST)
3. DATE OF FILING: 02/07/2013
Human
Human Resource 4. POSITION: CC II
Resource Department
Department 5. SALARY (MONTHLY)
Rm.
Rm.1507,
1507,15th
15thFlr.
Flr.CityState
CityStateCentre
Centre709
709Shaw
ShawBoulevard,
Boulevard,Pasig
PasigCity
City
Tel.
Tel.Nos.
DETAILS OF APPLICATION
Nos.638-3083/637-5648/637-9999
638-3083/637-5648/637-9999loc. loc.1522,
1522,1544
1544

6.a) TYPE OF LEAVE: 6.c) WHERE LEAVE WILL BE SPENT:

Vacation Leave (1) (In case of Vacation Leave)
Sick Leavepls specify / see attached med cert Within the Philippines
Special Privilege Leave / Abroad (Specify)
Forced Leave
Maternity Leave (2) (In case of Sick Leave)
Paternity Leave In-hospital (specif
Compensatory Leave / Out-patient (specify)see attached med cert
Solo Parent Leave
Others: TERMINAL LEAVE 6.d) COMMUTATION:
6.b) NO. OF CALENDAR DAYS APPLIED 28 days Requested Not requested
Inclusive dates: Feb 2-March 1, 2013

Signature of Employee

DETAILS OF ACTION ON APPLICATION

7.a) RECOMMENDING APPROVAL: 7.b)APPROVAL:

RECOMMENDED NOT RECOMMENDED APPROVED DISAPPROVED

Pls. state reason:

WALTER R. BACAREZA ATTY. ALEXANDER PADILLA DR. ENRIQUE T. ONA

Regional Vice President Chief Operating Officer Health Secretary/OIC-President & CEO PhilHealth

*Only the authorized signatory based on the Signing and Delegation of Authority shall be indicated here- see back for refer
FOR HRD/PhRO - HR UNIT USE ONLY

8.a) CERTIFICATION OF LEAVE CREDITS 8.b) PROCESSED FOR:

AS OF:_______________
No. of Days with Pay
No. of Days without Pay
VACATION SICK TOTAL Others (Specify)

8.c) HRD/PhRO HR Unit Action

EMMANUEL C. MONTILLA
HRMO III/Unit Head
 DISAPPROVED

Delegation of Authority shall be indicated here- see back for reference

 Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION ALA No.: _______________
Regional Office VIII
167 P. Burgos Street, Tacloban City 6500
Rep
Date Recd: ______________
Tel. (053) 523-8283
ubli Avaya 5608 Email: hr.pro8@philhealth.gov.ph Received by:_____________
c of
the
Phil
ippi
APPLICATION FOR LEAVE
nes
P
HI
ID No. 30437413 LI YOUNG EARL ALDWIN S
1. OFFICE/ AGENCY: P 2. NAME (FIRST) (MI)
PI (LAST)
3. DATE OF FILING: 1-23-19 N 4. POSITION: PA I 5. SALARY (MONTHLY)
E
DETAILS OF APPLICATION
H
6.a) TYPE OF LEAVE: 6.c) WHERE LEAVE WILL BE SPENT:
E
Vacation Leave AL (1) (In case of Vacation Leave)
Sick Leave (Specify Illness)FLUT Within the Philippines
Special Privilege Leave __________________
H Abroad (Specify)
Maternity Leave IN (2) (In case of Sick Leave)
Paternity Leave S In-hospital (Specify)
Compensatory Leave U Out-patient (Specify)
R
Solo Parent Leave
A
Others: __________ N
6.d) COMMUTATION:
C Requested Not requested
6.b) E
NO. OF WORKING DAYS APPLIED FOR: _____1_______
C
Inclusive dates: ________1-22-19_____________
O
R
Signature of Employee
P
FOR HRD/PRO
O - HR UNIT USE ONLY
7.a) CERTIFICATION OF LEAVE R CREDITS 7.b) PROCESSED FOR:
AT
AS OF: ________________ No. of Days with Pay
VACATION SICK IO TOTAL No. of Days without Pay
N
Hu
ma 7.c) HRD/PRO HR Unit Action
n
Re
Special COC Paternity/
so Solo Parent
urc
e
Others: De
pa
rt EMMANUEL C. MONTILLA
me HRMO III /HR Unit Head
Certified Correct by: _____________________________
nt
Rm.
1507,
DETAILS OF ACTION ON APPLICATION
15th
Flr.
CityS
8.a) RECOMMENDING APPROVAL: tate 8.b)APPROVAL:
Centr
e 709
RECOMMENDED NOT RECOMMENDED
Shaw
Boul APPROVED DISAPPROVED
evard
State reason: ,
Pasig
City
Tel.
Nos.
638-
3083/
637-
5648/
HENRY S. MADULA 637- ARLAN M. GRANALI
9999
Section / LHIO Head loc.
1522,
Division Chief
1544

*Only the authorized signatory based on the Signing and Delegation of Authority shall be indicated here- see back for refere
Signing and Delegation of Authority (Pursuant to Corporate Order No. 2016-0030)

Sick Leave / Vacation Leave including le

spent abroad/ Special Previlege/paternit Recommended by Approved by
Leave/Solo Parent Leave
7 days and below SG 26 RVP, as applicable RVP, AVP
Rank and File
including Non- Immediate Supervisor RVP
Regulars
8 days to 30 days SG 26 RVP, AVP EVP-COO
Rank and File
including Non- RVP AVP
Regulars
More than 30 days RVP/ OICs RVP, AVP, EVP-COO PCEO

Rank and File

including Non- RVP, AVP EVP-COO
Regulars
Request for Vacation Leave Extension: Only 1 request for extension is allowed for VL. Approving of
leave extension shall depend on the number of days and in accordance to the above signing authority of
leave. In case the approved leave of less than 30 calendar days is extended thereby cover a total of 30
calendar
Maternitydays or above,
leave/ Magna clearance shall
Carta for be required.
Wome Recommended by Approved by
RVP/ OICs RVP AVP

Rank and File

including Non- Immediate Supervisor RVP
Regulars
Study Leave/ Rehabilitation Leave Recommended by Approved by
RVP
RVP, AVP, SM-HRD, EVP-COO PCEO
Rank and File
including Non- RVP, AVP EVP-COO
Regulars
Terminal Leave Recommended by Approved by
Compulsory Retirement
RVP/ OICs AVP EVP-COO

Rank and File

including Non- Division Chief RVP, AVP
Regulars
Optional Retirement
RVP/ OICs RVP, AVP, EVP-COO PCEO

Rank and File

including Non- RVP, AVP EVP-COO
Regulars
Monetization of Leave Credits Recommended by Approved by
30 days & below RVP, AVP EVP-COO
RVP
More than 30
AVP, EVP-COO PCEO
days
Rank & File including Non-Regulars30 days & below Division Chief RVP
More than 30
RVP, AVP EVP-COO
days

Prescribed period of submission to the HR Unit:

Sick Leave: Within 2 working days upon return for work

Vacation Leave/Special Leave: At least 3 working days before effective of applied leave
Maternity Leave/ Vacation Leave Abroad: 1 month prior to effectivity of applied leave
File in 2 copies (1HR, 1 Employee)
Must be completely filled out.
Prescribed period of submission to the HR Unit:

Sick Leave: Within 2 working days upon return for work

Vacation Leave/Special Leave: At least 3 working days before effective of applied leave
Maternity Leave/ Vacation Leave Abroad: 1 month prior to effectivity of applied leave

File in 2 copies (1HR, 1 Employee)

Must be completely filled out.
 DISAPPROVED

elegation of Authority shall be indicated here- see back for reference

 rsuant to Corporate Order No. 2016-0030)

work
ys before effective of applied leave
prior to effectivity of applied leave
work
ys before effective of applied leave
prior to effectivity of applied leave
 Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION ALA No.: ______________
Regional Office VIII
167 P. Burgos Street, Tacloban City 6500
Rep Date Recd: ______________
Tel. (053) 523-8283
ubli Avaya 5608 Email: hr.pro8@philhealth.gov.ph Received by:_____________
c of
the
Phil
ippi
APPLICATION FOR LEAVE
nes
P
HI
ID No. LI
1. OFFICE/ AGENCY: P 2. NAME (FIRST)
PI (LAST)
N
3. DATE OF FILING: E 4. POSITION: 5. SALARY (MONTHLY)
DETAILS
H OF APPLICATION
6.a) TYPE OF LEAVE: E 6.c) WHERE LEAVE WILL BE SPENT:
Vacation Leave AL (1) (In case of Vacation Leave)
T
Sick Leave (Specify Illness)__________________ Within the Philippines
H
Special Privilege Leave __________________ Abroad (Specify)
IN
Maternity Leave S (2) (In case of Sick Leave)
Paternity Leave U In-hospital (Specify)
Compensatory Leave R Out-patient (Specify)
Solo Parent Leave A
Others: __________ N 6.d) COMMUTATION:
C Requested Not requested
E
6.b)
NO. OF WORKING DAYS APPLIED FOR: _____________
C
Inclusive dates: ______________________________
O
R
P Signature of Employee
O
DETAILS R OF ACTION ON APPLICATION
AT
7.a) RECOMMENDING APPROVAL: 7.b)APPROVAL:
IO
N
RECOMMENDED NOT Hu RECOMMENDED APPROVED DISAPPROVED
ma
State reason:
n
Re
so RENATO L. LIMSIACO, JR.
Immediate Supervisor urc Division Chief Regional Vice President
e
De
*Only the authorized signatory based onpathe Signing and Delegation of Authority shall be indicated here- see back for
rt
FOR HRD/PRO
me
- HR UNIT USE ONLY
8.a) CERTIFICATION OF LEAVE nt CREDITS 8.b) PROCESSED FOR:
Rm.
AS OF: ________________
1507, No. of Days with Pay
15th
VACATION SICK Flr.
CityS
TOTAL No. of Days without Pay
tate
Centr
e 709
Shaw 8.c) HRD/PRO HR Unit Action
Boul
evard
,
Special COC Paternity/
Pasig
City
Solo Parent
Tel.
Nos.
638-
3083/
637-
5648/
637-
9999
loc.
1522,
1544
 e 709
Shaw
Boul
evard
,
Pasig
City
Tel.
Nos.
638-
3083/
637-
Others: 5648/
637-
9999
loc. EMMANUEL C. MONTILLA
1522,
Certified Correct by: _____________________________
1544 HRMO III /HR Unit Head

Signing and Delegation of Authority (Pursuant to Corporate Order No. 2016-0030

Sick Leave / Vacation Leave including le

spent abroad/ Special Previlege/paternit Recommended by Approved by
Leave/Solo Parent Leave
7 days and below SG 26 RVP, as applicable RVP, AVP
Rank and File
including Non- Immediate Supervisor RVP
Regulars
8 days to 30 days SG 26 RVP, AVP EVP-COO
Rank and File
including Non- RVP AVP
Regulars
More than 30 days
RVP/ OICs RVP, AVP, EVP-COO PCEO

Rank and File

including Non- RVP, AVP EVP-COO
Regulars
Request for Vacation Leave Extension: Only 1 request for extension is allowed for VL. Approving of
leave extension shall depend on the number of days and in accordance to the above signing authority of
leave. In case the approved leave of less than 30 calendar days is extended thereby cover a total of 30
calendar days or above, clearance shall be required.
Maternity leave/ Magna Carta for Wome Recommended by Approved by

RVP/ OICs RVP AVP

Rank and File

including Non- Immediate Supervisor RVP
Regulars
Study Leave/ Rehabilitation Leave Recommended by Approved by
RVP
RVP, AVP, SM-HRD, EVP-COO PCEO

Rank and File

including Non- RVP, AVP EVP-COO
Regulars

Terminal Leave Recommended by Approved by

Compulsory Retirement
RVP/ OICs AVP EVP-COO

Rank and File

including Non- Division Chief RVP, AVP
Regulars
Optional Retirement
RVP/ OICs RVP, AVP, EVP-COO PCEO

Rank and File

including Non- RVP, AVP EVP-COO
Regulars
 Optional Retirement

Rank and File

including Non- RVP, AVP EVP-COO
Regulars
Monetization of Leave Credits Recommended by Approved by

30 days & below RVP, AVP EVP-COO

RVP
More than 30
AVP, EVP-COO PCEO
days
Rank & File including Non-Regulars30 days & below Division Chief RVP
More than 30
RVP, AVP EVP-COO
days

Prescribed period of submission to the HR Unit:

Sick Leave: Within 2 working days upon return for work

Vacation Leave/Special Leave: At least 3 working days before effective of applied leave
Maternity Leave/ Vacation Leave Abroad: 1 month prior to effectivity of applied leave

File in 2 copies (1HR, 1 Employee)

Must be completely filled out.
 No.: _______________
e Recd: ______________
eived by:_____________

(MI)

LL BE SPENT:

Not requested

DISAPPROVED

ated here- see back for reference

with Pay
without Pay
L C. MONTILLA
HR Unit Head

er No. 2016-0030)

Approved by

RVP, AVP

RVP

EVP-COO

AVP

PCEO

EVP-COO

VL. Approving of
igning authority of
cover a total of 30

Approved by

AVP

RVP

Approved by

PCEO

EVP-COO

Approved by

EVP-COO

RVP, AVP

PCEO

EVP-COO
 EVP-COO

Approved by

EVP-COO

PCEO

RVP

EVP-COO

e
e