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CSC Form No.

06

APPLICATION FOR LEAVE


Received July 1998 Application No. ______

Employee No.: _______________________________ TYPE OF LEAVE


Employee Name: _____________________________
Signature: ___________________________________ VACATION Within the Philippines
Position: ____________________________________ Abroad (specify) _________
Office/ Division: _____________________________ SICK Outpatient
Monthly Salary: ______________________________ In Hospital (specify) ______
Date of Filing:________________________________ MATERNITY
No. of working days applied for: _________________
Inclusive Date: OTHERS (specify) ________________________
From To ACTION ON APPLICATION
__________________ __________________ Recommending:
COMMUTATION
Approval Disapproval due to __________
Requested Not Requested
FOR PERSONNEL USE ONLY
Leave Credits as of VL SL TOTAL
JULIUS I. VILLAFUERTE
Officer-in-Charge, CMO-BCCAD
Less: This Leave
Leave Balance Approved Disapproved due to _______

Certified by: _______ Days with Pay


_______ Days w/o Pay

MA. CORAZON S. LIONG


ATTY. ZULEIKA T. LOPEZ
Community Affairs Officer III
City Administrator
Administrative Officer- Designate

CSC Form No. 06

APPLICATION FOR LEAVE


Received July 1998 Application No. ______

Employee No.: _______________________________ TYPE OF LEAVE


Employee Name: _____________________________
Signature: ___________________________________ VACATION Within the Philippines
Position: ____________________________________ Abroad (specify) _________
Office/ Division: _____________________________ SICK Outpatient
Monthly Salary: ______________________________ In Hospital (specify) ______
Date of Filing:________________________________ MATERNITY
No. of working days applied for: _________________
Inclusive Date: OTHERS (specify) ________________________
From To ACTION ON APPLICATION
__________________ __________________ Recommending:
COMMUTATION
Approval Disapproval due to __________
Requested Not Requested
FOR PERSONNEL USE ONLY
Leave Credits as of VL SL TOTAL
JULIUS I. VILLAFUERTE
Officer-in-Charge, CMO-BCCAD
Less: This Leave
Leave Balance Approved Disapproved due to _______

Certified by: _______ Days with Pay


_______ Days w/o Pay

MA. CORAZON S. LIONG


ATTY. ZULEIKA T. LOPEZ
Community Affairs Officer III
City Administrator
Administrative Officer- Designate

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