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Leave Form

1. Bianca Danica Regacho, a patrolwoman with the RHSU, is applying for 5 days of mandatory leave from December 13-17, 2021. 2. She has 30.48 days of vacation leave and 45.48 days of sick leave remaining. 3. The application is recommended for approval by her division chief and awaits final approval or disapproval by the authorized regional official.

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54 views2 pages

Leave Form

1. Bianca Danica Regacho, a patrolwoman with the RHSU, is applying for 5 days of mandatory leave from December 13-17, 2021. 2. She has 30.48 days of vacation leave and 45.48 days of sick leave remaining. 3. The application is recommended for approval by her division chief and awaits final approval or disapproval by the authorized regional official.

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© © All Rights Reserved
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CSC Form 6 Revised 1998

APPLICATION FOR LEAVE

1. Office/Agency 2. Name (Last) (First) (Middle)


RHSU Ugay Bianca Danica Regacho
3. Date of Filing 4. Position 5. Salary
November 5, 2021 Patrolwoman (Permanent) P29,668.00
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 X Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave


Maternity In hospital (Specify)
x Others (Specify)
Mandatory Leave Outpatient
Xx
6. C) Number of Working Days applied for: 6. D) Commutation
5 Days xxx Requested Not Requested
Inclusive Dates
December 13 – December 17, 2021

Signature of Applicant
49 San Eugenio, Aringay, L a Union
DETAILS OF ACTION ON APPLICATION
7. A) Certificate of Leave Credits 7. B) Recommendation:
as of November 5, 2021
Vacation Sick Total Approval
30.48 45.48 75.96
Disapproval due to

Total

PMAJ SALLY B SEGWABEN PCOL FABIANO B SUDARIO, JR


Chief, Personnel Division Authorized Official
7. C) Approved for: 7. D) Disapproved due to:
_________ days with pay
_________ days without pay
ANTONIO P MARALLAG JR
Police Colonel
Chief of the Regional Staff
(Authorized Official)
Date: _______________________________

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