APPLICATION FOR LEAVE APPLICATION FOR LEAVE

CS form 6 CS form 6
Revised 1984 CELL # _____________ Revised 1984 CELL # _____________

1. OFFICE / AGENCY 2. NAME (Last Name) (First Name) (Middle Name) 1. OFFICE / AGENCY 2. NAME (Last Name) (First Name) (Middle Name)
_Department of Education AGUILAR AURA ORILLO ___Department of Education AGUILAR AURA ORILLO
3. DATE OF FILING 4. POSITION 5. SALARY (Basic Monthly) 3. DATE OF FILING 4. POSITION 5. SALARY (Basic Monthly)
May 14, 2019 Principal 1 Php 42, 099.00 May 14, 2019 Principal 1 Php 42, 099.00

DETAILS FOR APPLICATION DETAILS FOR APPLICATION

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

Vacation (1). IN CASE OF VACATION LEAVE Vacation (1). IN CASE OF VACATION LEAVE
To seek Employment Within the Philippines To seek Employment Within the Philippines
Others ( Specify )______________ Abroad ( Specify ) _______ Others ( Specify )______________ Abroad ( Specify ) _______

( 2). IN CASE OF SICK LEAVE (2). IN CASE OF SICK LEAVE

Sick Sick
Maternity In Hospital ( Specify )______ Maternity In Hospital ( Specify )______
Others ( Specify )_ _______________ Out Patient ( Specify ) _____ Others ( Specify )_ _______________ Out Patient ( Specify ) _____

6. c) NUMBER OF WORKING DAYS APPLIED 6. d) COMMUTATION 6. c) NUMBER OF WORKING DAYS APPLIED 6. d) COMMUTATION
FOR : _________________________
2 days FOR : _________________________
2 days
Requested NOT Requested Requested NOT Requested
INCLUSIVE DATES INCLUSIVE DATES
_______________________________
May 9-10, 2019 _______________________________
May 9-10, 2019
_______________________ _____________________
Signature of Applicant Signature of Applicant
DETAILS OF ACTION ON APPLICATION DETAILS OF ACTION ON APPLICATION

7. a) Certification of Leave Credits 7. b) RECOMMENDATION 7. a) Certification of Leave Credits 7. b) RECOMMENDATION

as of _________________ as of _________________
Approved Approved
Disapproved due to _____________ Disapproved due to _____________
Vacation Sick Total Vacation Sick Total
______ _____ ______ ___________________________ ______ _____ ______ _____________________
______ ______ ______ ______ ______ ______
___________________________ ______________________

---------------------------------------------------------
__________________________ ISABELO D. ORAIS (Personnel Officer) ISABELO D. ORAIS
(Personnel Officer) (Authorized Official) (Authorized Official)
_________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________

7. c) APPROVED FOR 7. d) DISAPPROVED DUE TO: 7. c) APPROVED FOR 7. d) DISAPPROVED DUE TO:
____ Days with pay ________________________________________ ____ Days with pay ________________________________________
_____ Days without pay ________________________________________ _____ Days without pay ________________________________________
_____ Others (Specify) _____ Others (Specify)

________________________________ ________________________________
Signature Signature
Date: _______________________________ Date: _______________________________