Professional Documents
Culture Documents
For Reimbursement and Form 6
For Reimbursement and Form 6
₱ -
Prepared by:
NAME
I hereby certify that (1) I have reviewed the foregoing itinerary POSITION
(2) the travel is necessary to the service; (3) the period covered Approved by:
is reasonable and; (4) the expense claimed proper. ADELA C. LIBUNAO, ED.D
Secondary School Principal IV
CERTIFICATE OF TRAVEL COMPLETED
DepEd DEFEMNHS
(Agency) Station
I hereby certify that I have completed the travel authorized in Itinerary of Travel No._____
dated January 9, January 31, February 20, March 8, and March 13, 2023 under the conditions
indicated below:
Respectfully yours,
NAME
POSITION
On evidence and information of which I have knowledge, the travel was actually
undertaken
LOCATOR SLIP
NAME
Position/Designation
Permanent Station
Purpose of Travel
( must be supported by
Attachments)
Destination
Approved:
CERTIFICATION
To the concerned:
This is to certify that the above-named DepED official/personnel has visitied or appeared
in this Office/place for the purpose and during the date and time stated above.
To the concerned:
Position/Designation:
Office:
CERTIFICATION
Official Time
This is to certify that the above-named DepED official/personnel has visitie
in this Office/place for the purpose and during the date and time stated above.
CERTIFICATION
To the concerned:
NAME
Position/Designation
Permanent Station
Purpose of Travel
( Must be supported by
Attachments)
Host of Activity
Inclusive Dates
Destination
Local funds subject to the usual accounting and auditing rules
Fund Source
and regulations
I hereby attest that the information in this form and in the supporting documents attached hereto are true and correct
0
Name and Signature of Requesting Employee Date
This is to certify that the trip of the requesting employee satisfies all the minimum conditions for authorized official
travel and that alternatives to travel are insuffiecient for purpose stated herein.
Approved:
6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE
Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:
Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________
Sick Leave Abroad (Specify) _____________________________
✘
(Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) _____________________
✘
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness) ____________________
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) _____________________________________________
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) COLD AND FEVER
(Specify Illness) ________________________________
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) _____________________________________________
Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
Other purpose:
Others: Monetization of Leave Credits
_____________________________________ Terminal Leave
* For leave of absence for thirty (30) calendar days or more and terminal leave, application shall be accompanied by a clearance from money, property and
work-related accountabilities (pursuant to CSC Memorandum Circular No. 2, s. 1985).
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