CS Form 6 Revised 1984 APPLICATION FOR LEAVE 1, OFFICE/AGENCY 2. NAME: (Last) (First) (Middle) oer-ed cau Tae ee Navoo 3. DATE OF FILING 4, POSITION 5. SALARY (Monthly) oer. 217 THeHER- I Pho. 2eA62 DETAILS OF APPLICATION’ 6.a) TYPE OF LEAVE 6. b) WHERE LEAVE BE SPEN’ __Vacation (1) IN CASE OF VACATION LEAVE To seek employment Within the Philippines (Others (Specify) ‘Abroad (Specify) Sick (2.) IN CASE OF SICK LEAVE. Maternity Hospital (Specify) Others (Specify) Ont Patient (Specify) 6. c) NUMBER OF DAYS. 6. d) COMMUTATION APPLIED FOR ai Requested Not Requested INCLUSIVE DATES DETAILS OF ACTION ON APPLICATION 7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION ASOF __ a Approval Disapproval due to _ Vacation: Sick: Total: Weipa TT. VALENZELA Principal Administrative Officer 7. c) APPROVED FOR: 7. d) DISAPPROVED DUE TO: days with pay days without pay others (Specify) Date ie SEANARDO_A- ADINA Schools Division Superintendent 1. Applicaton for vacation or sick eave for one fll day or mare shal be made on the Form ato be accomplished in duplicate 2. Application fr vacation leave shall be fled in advance of whenever possible five (5) days before going on such leave 3. Application for sick leave file in advance or exceeding five (5) days shall be accompanied by a medical certificate. In case medical consultation were not availed of, an affidavit should be executed by the applicant. 4, _Anemployee who is absent without approved leave shall not be entitled to receive his salary corresponding the period of his unauthorized leave of absence 5 ‘An application for leave of absence fo thirty (30) calendar days or more shall be accompanied by a clearance from