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CSC FORM NO. 6 Revised 1984 APPLICATION FOR LEAVE 1. OFFICE/AGENCY 3. DATE OF FILING 2. NAME (Last) (First) (Middle Name) 4. POSITION 5. SALARY (Monthly) 6. DETAILS OF APPLICATION 6.a) TYPE OF LEAVE Vacation To seek employment Others (Specity) Sick Maternity Others (Specity) 6.c) NUMBER OF WORKING DAYS APPLIED ( ) INCLUSIVE DATES: 6. b) WHERE LEAVE WILL BE SPENT (1) IN CASE OF VACATION LEAVE Within the Philippines Abroad (Specify) (2) IN CASE OF SICK LEAVE In Hospital (Specify) Out Patient (Specify) 6. d) COMMUTATION Requested Not Requested (Signature of Applicant) 7. DETAILS OF APPLICATION ACTION ON 7.b) RECOMMENDATION Approval Disapproval due to (Authorized Official) 7.c) APPROVED FOR: Days with pay Days without pay Others (Specify) Date : RONNEL C. RIVERA City Mayor 7.d) DISAPPROVED DUE TO: By the Authority of the City Mayor: Gabriel Francis Glenville N. Gonzalez Asst. City Administrator-Administration CMO-ICTD NARIDO MARK JUNNIES GAHOB VACATION SICK TOTAL LEAH Y. TOLIMAO CGDH II 7.a) CERTIFICATION OF LEAVE CREDITS As of CSC FORM NO. 6 Revised 1984 APPLICATION FOR LEAVE 1. OFFICE/AGENCY 3. DATE OF FILING 2. NAME (Last) (First) (Middle Name) 4. POSITION 5. SALARY (Monthly) 6. DETAILS OF APPLICATION 6.a) TYPE OF LEAVE Vacation To seek employment Others (Specity) Sick Maternity Others (Specity) 6.c) NUMBER OF WORKING DAYS APPLIED ( ) INCLUSIVE DATES: 6. b) WHERE LEAVE WILL BE SPENT (1) IN CASE OF VACATION LEAVE Within the Philippines Abroad (Specify) (2) IN CASE OF SICK LEAVE In Hospital (Specify) Out Patient (Specify) 6. d) COMMUTATION Requested Not Requested (Signature of Applicant) 7. DETAILS OF ACTION ON APPLICATION 7.b) RECOMMENDATION Approval Disapproval due to (Authorized Official) 7.c) APPROVED FOR: Days with pay Days without pay Others (Specify) Date : RONNEL C. RIVERA City Mayor 7.d) DISAPPROVED DUE TO: By the Authority of the City Mayor: Gabriel Francis Glenville N. Gonzalez Asst. City Administrator-Administration CMO-ICTD NARIDO MARK JUNNIES GAHOB VACATION SICK TOTAL LEAH Y. TOLIMAO CGDH II 7.a) CERTIFICATION OF LEAVE CREDITS As of 1 Day 1 Day 1 Day 1 Day July 07, 2015 07/07/2015 DATA CONTROLLER II 14, 939.00 07/07/2015 DATA CONTROLLER II 14, 939.00 July 07, 2015

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  • CSC FORM NO. 6Revised 1984 APPLICATION FOR LEAVE

    1. OFFICE/AGENCY

    3. DATE OF FILING

    2. NAME (Last) (First) (Middle Name)

    4. POSITION 5. SALARY (Monthly)

    6. DETAILS OF APPLICATION

    6.a) TYPE OF LEAVE

    Vacation

    To seek employment

    Others (Specity)

    Sick

    Maternity

    Others (Specity)

    6.c) NUMBER OF WORKING DAYS APPLIED ( )

    INCLUSIVE DATES:

    6. b) WHERE LEAVE WILL BE SPENT

    (1) IN CASE OF VACATION LEAVE

    Within the Philippines

    Abroad (Specify)(2) IN CASE OF SICK LEAVE

    In Hospital (Specify)

    Out Patient (Specify)

    6. d) COMMUTATION

    Requested Not Requested

    (Signature of Applicant)

    7. DETAILS OF APPLICATIONACTION ON

    7.b) RECOMMENDATION

    Approval

    Disapproval due to

    (Authorized Official)

    7.c) APPROVED FOR:

    Days with pay

    Days without pay

    Others (Specify)

    Date :

    RONNEL C. RIVERACity Mayor

    7.d) DISAPPROVED DUE TO:

    By the Authority of the City Mayor:

    Gabriel Francis Glenville N. GonzalezAsst. City Administrator-Administration

    CMO-ICTD NARIDO MARK JUNNIES GAHOB

    VACATION SICK TOTAL

    LEAH Y. TOLIMAO CGDH II

    7.a) CERTIFICATION OF LEAVE CREDITSAs of

    CSC FORM NO. 6Revised 1984 APPLICATION FOR LEAVE

    1. OFFICE/AGENCY

    3. DATE OF FILING

    2. NAME (Last) (First) (Middle Name)

    4. POSITION 5. SALARY (Monthly)

    6. DETAILS OF APPLICATION

    6.a) TYPE OF LEAVE

    Vacation

    To seek employment

    Others (Specity)

    Sick

    Maternity

    Others (Specity)

    6.c) NUMBER OF WORKING DAYS APPLIED ( )

    INCLUSIVE DATES:

    6. b) WHERE LEAVE WILL BE SPENT

    (1) IN CASE OF VACATION LEAVE

    Within the Philippines

    Abroad (Specify)(2) IN CASE OF SICK LEAVE

    In Hospital (Specify)

    Out Patient (Specify)

    6. d) COMMUTATION

    Requested Not Requested

    (Signature of Applicant)

    7. DETAILS OF ACTION ON APPLICATION

    7.b) RECOMMENDATION

    Approval

    Disapproval due to

    (Authorized Official)

    7.c) APPROVED FOR:

    Days with pay

    Days without pay

    Others (Specify)

    Date :

    RONNEL C. RIVERACity Mayor

    7.d) DISAPPROVED DUE TO:

    By the Authority of the City Mayor:

    Gabriel Francis Glenville N. GonzalezAsst. City Administrator-Administration

    CMO-ICTD NARIDO MARK JUNNIES GAHOB

    VACATION SICK TOTAL

    LEAH Y. TOLIMAO CGDH II

    7.a) CERTIFICATION OF LEAVE CREDITSAs of

    1 Day 1 Day

    1 Day 1 Day

    July 07, 2015

    07/07/2015 DATA CONTROLLER II 14, 939.00

    07/07/2015 DATA CONTROLLER II 14, 939.00

    July 07, 2015

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