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Application For Leave: 9 Days Below)

Nona Shella Diaz, a teacher working for DepEd Calapan, applied for 1 day of sick leave on September 29, 2020. Her application was approved by Principal Lorraine F. Sangalang and the OIC of the Assistant Schools Division Superintendent, Lynn G. Mendoza. The document outlines the process for applying for different types of leave and notes requirements like submitting medical certificates for sick leave exceeding 5 days.

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Nona Shella Diaz Abelgas
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117 views3 pages

Application For Leave: 9 Days Below)

Nona Shella Diaz, a teacher working for DepEd Calapan, applied for 1 day of sick leave on September 29, 2020. Her application was approved by Principal Lorraine F. Sangalang and the OIC of the Assistant Schools Division Superintendent, Lynn G. Mendoza. The document outlines the process for applying for different types of leave and notes requirements like submitting medical certificates for sick leave exceeding 5 days.

Uploaded by

Nona Shella Diaz Abelgas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CSC Form 6

Revised 1994

APPLICATION FOR LEAVE


(9 DAYS BELOW)
__________________________________________________________________________________________________
1.OFFICE/AGENCY 2. NAME (Last) (First) (Middle)

DepEd Calapan ABELGAS NONA SHELLA DIAZ


3. Date of Filing 4. Position 5. Salary (Month)

September 30, 2020 TEACHER II ₱ 24,495.00


DETAILS OF APPLICATION
6. a ) TYPE OF LEAVE 6. b ) WHERE LEAVE WILL BE SPENT
/ /Vacation ( 1 ) IN CASE OF VACATION
_________To seek employment / / within the Philippines
_________ Others ( Specify ) / / Abroad (Specify)_______________________
/ √ / Sick ( 2 ) IN CASE OF SICK LEAVE
/ /Maternity / / In hospital ( Specify )____________________
/ / Others (Specify___________________ / / Outpatient ( Specify )____________________

6. c ) NUMBER OF WORKING DAY/S 6. d ) COMMUTATION


APPLIED FOR_ 1 day_ ________________ _____Requested ____Not Requested
INCLUSIVE DATES September 29, 2020

__________________________________________
Signature of Applicant

Employee No .__4742326___________

DETAILS OF ACTION ON APPLICATION

7. a ) CERTIFICATION OF LEAVE CREDITS ___________________________________________


AS OF ____________________________ 7. b ) RECOMMENDATIONS
________ Approval
_________________________________________ ________Disapproval due to____________________
Vacation Sick Total ___________________________________
_______ _________ ___________

_________________________________ LORRAINE F. SANGALANG


Administrative Officer V Principal II

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


____________________ days with pay _______________________________
____________________ days without pay _______________________________
____________________ others (Specify )

Date:______________________

___LYNN G. MENDOZA___
OIC-Office of the Assistant Schools Division Superintendent

Note:
1. Applicant for vacation leave or sick leave for one full day or more be made on this form to be accomplish at least in duplicate
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going on such leave.
3. Application for sick leave filled in advance or exceeding five days shall be accompanied by medical certificate. In case of medical certificate was
not availed or an affidavit should be 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 unauthorized
leave of Absence.
5. An application for leave of absence of thirty (30) calendar days or more shall be accompanied by accompanied by clearance from money and
property accountability.
CSC Form 6
Revised 1994

APPLICATION FOR LEAVE


(9 DAYS BELOW)
__________________________________________________________________________________________________
1.OFFICE/AGENCY 2. NAME (Last) (First) (Middle)

3. Date of Filing 4. Position 5. Salary (Month)

DETAILS OF APPLICATION
6. a ) TYPE OF LEAVE 6. b ) WHERE LEAVE WILL BE SPENT
/ /Vacation ( 1 ) IN CASE OF VACATION
_________To seek employment / / within the Philippines
_________ Others ( Specify ) / / Abroad (Specify)_______________________
/ / Sick ( 2 ) IN CASE OF SICK LEAVE
/ /Maternity / / In hospital ( Specify )____________________
/ / Others (Specify) ___________________ / / Outpatient ( Specify )____________________

6. c ) NUMBER OF WORKING DAY/S 6. d ) COMMUTATION


APPLIED FOR__ _____________ _____Requested ____Not Requested
INCLUSIVE DATES:__ ___

__________________________________________
Signature of Applicant

Employee No .________________________

DETAILS OF ACTION ON APPLICATION

7. a ) CERTIFICATION OF LEAVE CREDITS ___________________________________________


AS OF ____________________________ 7. b ) RECOMMENDATIONS
________ Approval
_________________________________________ ________Disapproval due to____________________
Vacation Sick Total ___________________________________
_______ _________ ___________

___________________________________ LORRAINE F. SANGALANG


Administrative Officer V Principal II

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


____________________ days with pay _______________________________
____________________ days without pay _______________________________
____________________ others (Specify )

Date:______________________

___LYNN G. MENDOZA___
OIC-Office of the Assistant Schools Division Superintendent

Note:
1. Applicant for vacation leave or sick leave for one full day or more be made on this form to be accomplish at least in duplicate
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going on such leave.
3. Application for sick leave filled in advance or exceeding five days shall be accompanied by medical certificate. In case of medical certificate was
not availed or an affidavit should be 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 unauthorized
leave of Absence.
5. An application for leave of absence of thirty (30) calendar days or more shall be accompanied by accompanied by clearance from money and
property accountability.

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