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Application For Leave: (Signature of Applicant)

This document is an application for leave form from a government office. It requests information such as the applicant's name, position, type of leave being requested, number of working days for leave, and certification of leave credits. The form is to be filled out in duplicate and requires recommendations and approvals from authorized officials. Instructions note that applications for vacation leave should be filed 5 days in advance, and applications for sick leave exceeding 5 days require a medical certificate or affidavit. Employees absent without approved leave will not receive salary for the period. Applications for 30 days or more require clearance of money and property accountability.

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54 views26 pages

Application For Leave: (Signature of Applicant)

This document is an application for leave form from a government office. It requests information such as the applicant's name, position, type of leave being requested, number of working days for leave, and certification of leave credits. The form is to be filled out in duplicate and requires recommendations and approvals from authorized officials. Instructions note that applications for vacation leave should be filed 5 days in advance, and applications for sick leave exceeding 5 days require a medical certificate or affidavit. Employees absent without approved leave will not receive salary for the period. Applications for 30 days or more require clearance of money and property accountability.

Uploaded by

Dreamy Bernas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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CSC Form No.

6 IMPORTANT-
ALWAYS INDICATE IN
FORMS 6 & 48 YOUR
EMPLOYEE NO. ______________

APPLICATION FOR LEAVE


1. OFFICE/AGENCY: 2. NAME: (Last)) (First)) (Middle)

3. DATE OF FILING: 4. POSITION: 5. SALARY (Monthly)

DETAILS OF APPLICATION
6. a) TYPE OF LEAVE: 6. b) WHERE LEAVE WILL BE SPENT:
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 In Hospital (Specify)
OTHERS (Specify) _________________________________________
_____________________________________ Out Patient (Specify)
_________________________________________
6. c) NUMBER OF WORKING DAYS APPLIED 6. d) COMMUTATION:
FOR _____________________________ Requested
INCLUSIVES DATES: Not Requested
________________________________ ________________________________________
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION:
As of ____________________________ Approval
_________________________________ Disapproval
Vacation Sick Total due to _______________________________
SC : ______________ _____________ ______
Less: ______________ _____________ ______
Bal. : ______________ _____________ ______
days days days

ARIEL B. ANDUTAN __________________________


Administrative Officer V (Authorized Official)

7. c) APPROVED FOR: 7. d) DISAPPROVED DUE TO:


_________ days with pay
_________ days without pay _________________________________________
_________ others (specify) _________________________________________

INSTRUCTION
1. Application for vacation or sick leave for one full day or more shall be made on this form to be accomplished at least in duplicate.
2. Application for vacation leave shall be filed in advance or wherever possible five (5) days before going on such leave.
3. Application for sick leave filed in advance or exceeding five (5) days shall be accompanied by a medical certificate.
In case medical consultation was not availed of, an affidavit shoul be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive his salary corresponding to the
period of his unathorized leave of absence.
5. An application for leave of absence for thirty (30) days or more shall be accompanied by clearance from
money and property accountability.

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