CSC Form 6
APPLICATION FOR LEAVE
OFFICE/AGENCY NAME(Last) (First) (Middle)
DepEd. - Division of Tarlac Province DE PANO PAULINO D.
Date of Filing Position Salary
February 13, 2018 CID-CES
DETAILS ON APPLICATION
6.a) Type of Leave 6.b.) WHERE LEAVE WILL BE SPENT
1. In case of vacation leave:
Vacation X Within the Philippines
To seek employment Abroad (Specify)
Sick
Maternity 2. In case of sick leave:
X Others (Specify) In hospital (Specify)
FORCE LEAVE
c)Number of working days applied for: out-patient (Specify)
1 DAY
Inclusive date/s: February 23, 2018 COMMUTATION:
Requested Not Requested
Signature of Applicant
DETAILS ON ACTION ON APPLICATION
7.a) Certification of Leave Credits as of: 7.b) Recommendations:
Vacation Sick Total Approved
Disapproved due to
JOVITA G. DIZON
Administrative Officer V
7.c)APPROVED FOR: 7.d) DISAPPROVED DUE TO:
1 Day/s with pay
day/s without pay
Others (Specify)
DR. ESTRELITA SAGMIT CUNANAN
OIC-Schools Division Superintendent
Authorized Official