APPLICATION FOR LEAVE

1. OFFICE OR AGENCY 2. NAME (Last) (First) (M)

Provincial Legal Office (PLO) SANTOS , MIKHAEL O.
2. Date of Filing 3. Position 4. Salary (Monthly)
August 31, 2021 Attorney III

6. (a) Type of Leave: 6. (b) Where leave will be spent?

( ) Vacation Leave 1.) In case of Vacation Leave:

( ) To Seek Employment ( x ) Within the Philippines

( ) Forced Leave ( ) Abroad

( ) Maternity Leave
2.) In case of sick leave:
(x) Sick Leave ( ) In Hospital (Specify)

( ) Others (Specify) ( ) Out Patient (Specify)

6. (c) Number of working days applied for: 6. (d) Commutation:

( )Requested
August 24, 2021 ( ) Not Request
One Day

ATTY. MIKHAEL O. SANTOS

7. (a) Certificate of leave credits
as of ________________________
Vacation Leave Sick Leave
______________________________
(Signature of Applicant)
7. (b) Recommendations:
( ) Approval
( ) Disapproval due to
_________________________________________

JOCELYN J. ADDUN ATTY. ROSA LEAH L. TEPACE-ESTUDILL

Human Resource Management Officer Provincial Legal Officer

APPROVED for: DISAPPROVED due to:

________________day/s with pay _________________________________

________________day/s without pay _________________________________

EDWIN MARINO C. ONGCHUAN

Governor
DATE: _________________

CSC Form No. 6