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Form 6

The document is an application form for leave within the Department of Education in the Philippines, specifically for the Schools Division of Cebu Province. It outlines various types of leave available to employees, including vacation, sick, maternity, and special privilege leave, along with sections for detailing the leave request and action on the application. The form requires personal information, leave details, and signatures from authorized officers for approval or disapproval of the leave request.

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146 views2 pages

Form 6

The document is an application form for leave within the Department of Education in the Philippines, specifically for the Schools Division of Cebu Province. It outlines various types of leave available to employees, including vacation, sick, maternity, and special privilege leave, along with sections for detailing the leave request and action on the application. The form requires personal information, leave details, and signatures from authorized officers for approval or disapproval of the leave request.

Uploaded by

beamae.genobaten
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 ANNEX A
Revised 2020
Republic of the Philippines
Department of Education
Schools Division of Cebu Province
DATE OF RECEIPT

APPLICATION FOR LEAVE


1. OFFICE/DEPARTMENT 2. NAME : (Last) (First) (Middle)
DEPED – TONGGO IS

3. DATE OF FILING 4. POSITION 5. SALARY


6. 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 E.O. No. 292) In case of Vacation/Special Privilege Leave:
Mandatory/Forced Leave(Sec.25, Rule XVI, Omnibus Rules Implementing E.O. No.292) Within the Philippines
Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify)
Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:

Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness)
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (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. No. 292) In case of Special Leave Benefits for Women:

10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness)
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s.2010) In case of Study Leave:

Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
Adoption Leave(R.A. No. 8552) BAR/Board Examination Review

Other purpose:
Others: Monetization of Leave Credits
PERSONAL LEAVE
Terminal Leave

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


Not Requested
INCLUSIVE DATES Requested

(Signature of Applicant)

7. DETAILS OF ACTION ON APPLICATION


7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
As of
For approval
Vacation
Leave Sick
Leave
For disapproval due
Total Earned
Less this application
Balance

LEONIZA E. TORRES JUDY R. TAPERE, DevEdD

(Authorized Officer) (Authorized Officer)

7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:


days with pay
days without pay
others (Specify)
Civil Service Form No.6 ANNEX A
Revised 2020
Republic of the Philippines
Department of Education
Schools Division of Cebu Province
DATE OF RECEIPT

_______________________
(Authorized Official)
(Authorized

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