National Capital Region

Schools Division Office, Caloocan City

M AYPAJO H IGH S CHOOL

Team MHS: Together, Everyone Achieves More.

CS Form No. 6
Revised 1994
OFFICE/AGENCY 2. NAME (Last) (First) (Middle)
DepEd, Maypajo High School
DATE OF FILING POSITION SALARY (Monthly)

DETAILS OF APPLICATION
6. a) TYPE OF LEAVE 6. b) WHERE LEAVE BE SPENT
Vacation 1. IN CASE OF VACATION LEAVE
To seek employment Within the Philippines
Others (Specify) _______________________ ADDRESS:
Sick Abroad
Maternity ADDRESS: ____________________________
Others (Specify)
2. IN CASE OF SICK LEAVE
In Hospital
ADDRESS: ___________________________
6. c) NUMBER OF WORKING DAYS Out Patient
APPLIED FOR : ADDRESS: _______________________

6. d) COMMUTATION
Requested Not Requested
INCLUSIVE DATES:

____________________________________
Teacher
DETAILS OF ACTION ON APPLICATION
7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION
as of ------------------------------------- Approval
_____________________________________ Disapproval due to --------------------------------
Vacation Sick Total_ _ -------------------------------------------------
_____________________________________
Days Days Days___

MARIANNE B. GARCIA
Administrative Officer IV MARIA CONCEPCION S. GUTIERREZ, PhD.
Personnel Section Principal
7. c) APPROVED FOR: 7. d) DISAPPROVED DUE TO:
__ __ days with full pay ---------------------------------------
____ day without pay ---------------------------------------
______ Others (Specify)

CAROLINA T. RIVERA
OIC – Office of the Asst. Schools Division Superintendent

J. P. Rizal St., Maypajo, Caloocan City (02) 285-0407 maypajohighschool@yahoo.com

 National Capital Region
Schools Division Office, Caloocan City

M AYPAJO H IGH S CHOOL

Team MHS: Together, Everyone Achieves More.

_____________________ , 2018

Ms. CAROLINA T. RIVERA

Officer-In-Charge
Office of the Asst. Schools Division Superintendent
Schools Division Office
Caloocan City

Thru: The PERSONNEL SECTION

M A D A M:

I regret to inform your good office that I have incurred __________ ( ) day/s leave
of absence last _______________________, 2018 due to .

Hoping for your kind understanding on this matter.

Thank you very much.

Very truly yours,

Teacher
NOTED:

Department Head/ Coordinator

J. P. Rizal St., Maypajo, Caloocan City (02) 285-0407 maypajohighschool@yahoo.com