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Form 6

This document is a Civil Service Form No. 6 application for leave submitted by Jeric Bocter Maribao, a T-III position employee at the Department of Education Region X Schools Division of Misamis Occidental. Maribao is applying for a 5-day vacation leave from October 9-13, 2023. The form provides spaces to fill in details of the applicant's position and salary, type of leave being applied for, number of days, certification of available leave credits, recommendations of approving officers, and space for the final approval or disapproval by the Schools Division Superintendent.

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Jeric Maribao
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496 views2 pages

Form 6

This document is a Civil Service Form No. 6 application for leave submitted by Jeric Bocter Maribao, a T-III position employee at the Department of Education Region X Schools Division of Misamis Occidental. Maribao is applying for a 5-day vacation leave from October 9-13, 2023. The form provides spaces to fill in details of the applicant's position and salary, type of leave being applied for, number of days, certification of available leave credits, recommendations of approving officers, and space for the final approval or disapproval by the Schools Division Superintendent.

Uploaded by

Jeric Maribao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Civil Service Form No.

6
Revised 2020
Republic of the Philippines
Department of Education
Region X
Schools Division of Misamis Occidental
Oroquieta City
APPLICATION FOR LEAVE
1. OFFICE/AGENCY 2. NAME: (Last) (First) (Middle Name)
DEPED-MIS.OCC MARIBAO JERIC BOCTER

3. DATE OF FILLING SEPTEMBER 29, 2023 4. POSITION T-III 5. SALARY 31,320.00


DETAILS OF APPLICATION
6. A. TYPE OF LEAVE TO BE AVAILED OF 6. B. DETAILS OF LEAVE
Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing In case of Vacation/ Special Privilege Leave:
E.O. No. 292) Within the Philippines ___________________________
Mandatory/ Forced Leave (Sec. 25, Rule XVI, Omnibus Rules Abroad (Specify) __________________________
Implementing E.O. No. 292)
Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. In case of Sick Leave :
No. 292) In Hospital (Specify Illness) _______________________
Maternity Leave (R.A. No. 11210/IRR issued by CSC, DOLE and SSS) Out Patient (Specify Illness) ______________________
Paternity Leave (R.A 8187/CSC MC no. 71, s. 1998, as amended)
Special Privilege Leave (Sec.21, Rule XVI, Omnibus Rules In case OF Special Leave Benefits for Women:
Implementing E.O. No. 292) (Specify Illness) ______________________________
Solo Parent Leave (RA No. 8972/CSC MC No. 8, s. 2004)
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. In case of Study Leave:
No. 292) Completion Of Master’s Degree
10-Day VAWC Leave ( RA No. 9262/CSC MC No. 15, s. 2005) BAR/ Board Examination Review
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules
Implementing E.O. No. 292) Other Purpose:
Special Leave Benefits for Women (RA No. 9710/ CSC MC No. 25, s. Monetization of Leave Credits
2010 Terminal Leave
Special Emergency (Calamity) Leave ( CSC MC No. 2, s. 2012, as amended)
Adoption Leave (RA No. 8552)

Others:
_____________________________________________________

6.C. NUMBER OF WORKING DAYS APPLIED FOR 6. D. COMMUTATION


____5 days___________ Not Requested
INCLUSIVE DATES Requested
____OCTOBER 9-13, 2023________
__________________________
Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A. CERTIFICATION OF LEAVE CREDITS 7. B. RECOMMENDATION
As of ______________________
Vacation Leave Sick Leave For Approval
Total Earned For disapproval due to ______________________________
Less this application _________________________________________________
__________________________________________________
Balance

JOHNNY M. BELOY MIGUEL RAFAEL B. MEDIJA III, HT-I


Administrative Officer V OIC, Office of the School Principal
(Authorized Officer) (Authorized Officer)

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


__________DAY/S WITH PAY _____________________
__________DAYS WITHOUT PAY _____________________
__________OTHERS (SPECIFY) _____________________
_________________________

REYNALDO E. MANUEL JR., PH.D, CESO V


Schools Division Superintendent
(Authorized Officer)
DATE: __________________

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