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Application For Leave: Division of Bukidnon

This document is an application for leave form from the Department of Education Division of Bukidnon. It collects information such as the applicant's name, position, salary, type of leave being requested, inclusive dates of leave, and leave credit balances. The form is then signed by the applicant's immediate head and authorized officials to recommend approval or disapproval of the leave. If approved, the Schools Division Superintendent signs to approve the requested days of leave with or without pay. Instructions at the bottom specify that vacation leave must be applied for in advance while sick leave of 5 days or more requires a medical certificate.

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0% found this document useful (0 votes)
67 views1 page

Application For Leave: Division of Bukidnon

This document is an application for leave form from the Department of Education Division of Bukidnon. It collects information such as the applicant's name, position, salary, type of leave being requested, inclusive dates of leave, and leave credit balances. The form is then signed by the applicant's immediate head and authorized officials to recommend approval or disapproval of the leave. If approved, the Schools Division Superintendent signs to approve the requested days of leave with or without pay. Instructions at the bottom specify that vacation leave must be applied for in advance while sick leave of 5 days or more requires a medical certificate.

Uploaded by

kristine diaz
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 XLSX, PDF, TXT or read online on Scribd
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DEPARTMENT OF EDUCATION

Region X - Northern Mindanao


DIVISION OF BUKIDNON
Fortich Street, Sumpong, Malaybalay City
www.depedbukidnon.net.ph
APPLICATION FOR LEAVE
CSC Form 6
(Revised 2015)
1. Office/Agency Employee ID/Number:
DepED - Division of Bukidnon School/Office: `
District:
Employee Contact Number:

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

3. Date of Filing: 4. Position:


5. Monthly Salary:

6. a. Type of Leave 6.b. Where leave will be spent in case of Vacation Leave?
Vacation Leave
To seek employment
Forced Leave
Sick Leave In case of Sick Leave, please specify the place of recovery.
Maternity Leave
Others (Please specify)

Commutation Requested
7. Number of working days applied: Not Requested
Inclusive dates: 9/22/2017

(Signature over Printed Name of Employee)

NESTOR G. MONTEJO
(Signature over Printed Name of Immediate Head)

DETAILS OF ACTION ON APPLICATION


7. A. Certification of Leave Credits 7. B. Recommendation
Vacation Leave Credits Sick Leave Credits Total Leave Credits Vacation Leave Credits Sick Leave Credits Total Leave Credits

RICHARD LEY M. PORTILLAS JANINE S. ORONG


Authorized Official Administrative Officer IV
7. C. APPROVED FOR: 7. D. DISAPPROVED due to:

days with pay

days without pay

RANDOLPH B. TORTOLA
Schools Division Superintendent
1. Application for vacation or sick leave for one full day or more shall be made on this form and to be accomplished in four copies.
2. Application for vacation leave shall be filed in advance. In case of sick leave five days and above shall be accompanied with medical certificate.
3. An employee who is absent without approved leave shall not be entitled to receive his salary corresponding the period his authorized leave of absence.

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