APPLICATION FOR LEAVE

CSC FORM 6 Employee No.: ________________

1. Office/Agency
DepEd Alaminos City Diision
!" Name (Last) (First) (Middle)

3. Date of Filling #" Position

$" Sala%y

6. a. TYPE OF LEAVE 6" &" '(ERE LEAVE 'ILL &E SENT
! Vacation
! To "ee# Employment
! Ot$e%" &'pecify(
))))))))))))
! 'ic#
! *ate%nity
! Ot$e%" &'pecify(
))))))))))))))) )))))
6. c. N+*,E- OF .O-/0N1 DAY'
APPL0ED FO-

))))))))))))))))))))))))))))

0ncl2"i3e Date":

_________________________
)" IN CASE OF VACATION
* + 'it,in t,e P,ilippines
* + A-%oad .Spe/i0y1
___________________________

!" IN CASE OF SIC2 LEAVE
* + In (ospital .Spe/i0y1
________________________
* + O3t Patient
____________________________
6" d" COMM4TATION
* + Re53ested
* + Not Re53ested
__________________________
(Signature of Applicant)
4. a. 5E-T0F05AT0ON OF LEAVE 5-ED0T'
a" of

Vacation 'ic# Total
A4RORA 6" SARMIENTO
Administrative Officer V
7" -" RECOMMENDATION
* + App%oed __ 8it, pay
__ 8it,o3t pay
* + Disapp%oed d3e to

4. c. APP-OVED FO-:
)))) Day" 6it$ pay
Day" 6it$o2t pay
Ot$e%" &'pecify(
7" d" DISAPPROVED D4E TO9
__________________________________
APP-OVED:
OSCAR C" TADEO: Ed" D"
Asst. Schools Division Superintendent
Officer In- Charge