HQP-HRF-056

Pag-IBIG Fund
APPLICATION FOR LEAVE
LAST NAME FIRST NAME M.I. POSITION ID NO.

LEAVE APPLIED FOR REASON FOR LEAVE (SPECIFY)

□ VACATION □ SICK □ EMERGENCY □ FUNERAL
□ FORCED □ MATERNITY □ TERMINAL □ BIRTHDAY
□ PATERNITY □ ENROLLMENT □ HOSPITALIZATION □ ACCIDENT
□ GRADUATION □ WEDDING/
ANNIVERSARY
INCLUSIVE DATES NO. OF DAYS SIGNATURE OF APPLICANT

COMMUTATION RECOMMENDED BY
DATE OF FILING
DATES □ REQUESTED □ NOT REQUESTED □ APPROVED □ DISAPPROVED
REMARKS

SIGNATURE OVER PRINTED NAME

THIS PORTION TO BE FILLED UP BY HRMDD

SALARY PER MONTH □ WITH PAY FOR □ WITHOUT PAY FOR

APPROVED BY
___DAYS ___DAYS
LEAVE CREDITS AS OF: CERTIFIED BY: REMARKS
SICK LEAVE:
□ APPROVED □ DISAPPROVED
VACATION LEAVE:
REMARKS: ASSISTANT MANAGER
RECEIVED BY: DATE: SIGNATURE OVER PRINTED NAME

Note: Please refer to Office Order No. 2012-022 Series of 2012 Signing Authority for Administrative Services Transactions for All HDMF Offices.

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HQP-HRF-056

Pag-IBIG Fund
APPLICATION FOR LEAVE
LAST NAME FIRST NAME M.I. POSITION ID NO.

LEAVE APPLIED FOR REASON FOR LEAVE (SPECIFY)

□ VACATION □ SICK □ EMERGENCY □ FUNERAL
□ FORCED □ MATERNITY □ TERMINAL □ BIRTHDAY
□ PATERNITY □ ENROLLMENT □ HOSPITALIZATION □ ACCIDENT
□ GRADUATION □ WEDDING/
ANNIVERSARY
INCLUSIVE DATES NO. OF DAYS SIGNATURE OF APPLICANT

COMMUTATION RECOMMENDED BY
DATE OF FILING
DATES □ REQUESTED □ NOT REQUESTED □ APPROVED □ DISAPPROVED
REMARKS

SIGNATURE OVER PRINTED NAME

THIS PORTION TO BE FILLED UP BY HRMDD

SALARY PER MONTH □ WITH PAY FOR □ WITHOUT PAY FOR

APPROVED BY
___DAYS ___DAYS
LEAVE CREDITS AS OF: CERTIFIED BY: REMARKS
SICK LEAVE:
□ APPROVED □ DISAPPROVED
VACATION LEAVE:
REMARKS: ASSISTANT MANAGER
RECEIVED BY: DATE: SIGNATURE OVER PRINTED NAME

Note: Please refer to Office Order No. 2012-022 Series of 2012 Signing Authority for Administrative Services Transactions for All HDMF Offices.