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Application For Leave (Form 6)

The document is an application form for requesting leave from work. It collects information such as the applicant's office, name, date of filing, position and salary. It asks for details of the leave application such as the type of leave (e.g. vacation, sick), where the leave will be spent, the number of working days requested and inclusive dates. The form also includes sections for certifying the applicant's leave credits, recommendations for approving or disapproving the request, and signatures from the authorized official. Instructions at the bottom specify the procedures for applying for different types of leaves.

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MARCELINA CABARING
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355 views1 page

Application For Leave (Form 6)

The document is an application form for requesting leave from work. It collects information such as the applicant's office, name, date of filing, position and salary. It asks for details of the leave application such as the type of leave (e.g. vacation, sick), where the leave will be spent, the number of working days requested and inclusive dates. The form also includes sections for certifying the applicant's leave credits, recommendations for approving or disapproving the request, and signatures from the authorized official. Instructions at the bottom specify the procedures for applying for different types of leaves.

Uploaded by

MARCELINA CABARING
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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APPLICATION FOR LEAVE

CSC Form No. 6


Revised 1984
1. OFFICE/AGENCY 2. NAME (Last) (First) (Middle)
WEST I DISTRICT, __________________

3. DATE OF FILING 4. POSITION 5. SALARY

6. DETAILS OF APPLICATION
6. (a) TYPE OF LEAVE 6. (b) WHERE LEAVE WILL BE SPENT
_____________ Vacation Leave 1. IN CASE OF VACATION LEAVE
_____________ To seek employment ______ Within the Philippines
_____________ Others (Specify) _______________ ______ Abroad (Specify) _____________
_____________________________
_____________________________ 2. IN CASE OF SICK LEAVE
6. (c) NUMBER OF WORKING DAYS APPLIED FOR ______ In Hospital (Specify) __________
_____________________________ ______ Out Patient (Specify) __________
_____________________________
INCLUSIVE DATES: ___________________________ 6. (d) COMMUTATION
_____________________________ ______ Requested ______ Not Requested
_____________________________

________________________________
Signature of Applicant

7. DETAILS OF ACTION ON APPLICATION


7. (a) CERTIFICATION OF LEAVE CREDITS 7. (b) RECOMMENDATION

As of ____________________________________ __________ APPROVED


__________ DISAPPROVED due to ____
VACATION SICK TOTAL _______________________
_______________________

________________________________
DAYS DAYS DAYS Authorized Official

_______________________________________

7. (c) APPROVED FOR: 7. (d) DISAPPROVED due to:


______ DAYS WITH PAY _________________________________
______ DAYS WITHOUT PAY _________________________________
______ OTHERS (Specify) _________________________________

______________________________________
Signature

Date ___________________________________ ______________________________________


Authorized Official
1. Application for Vacation or Sick Leave for one full day or more shall be made in this form and to be
accomplished at least in duplicate.
2. Application for Vacation Leave shall be filed in advance or whenever possible five (5) days before
going such leave.
3. Application for Sick Leave filed in advance or exceeding five (5) days shall be accomplished by a
Medical Certificate. In case medical consultation was not availed of, an affidavit should be executed by
then.
4. An employee who is absent without approved leave shall not be entitled to receive his/her salary
corresponding to the period of his/her salary unauthorized leave of absence.
5. An application of leave of absence for thirty (30) calendar days or more shall be accomplished by a
clearance from money and property accountability.

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