CSC Form No.

6
(For Teachers)

1 Office Agency: 2 Name (Last) (First) (MI)

DepEd -
3 Date of Filing: 4 Position: 5 Salary (Monthly)

6 Type of Leave: 7 Where Leave will be spent:

Vacation In case of Vacation Leave
To seek employment Within the Philippines
Sick Abroad (Specify)
Maternity
Others (Specify) In case of Sick Leave
In Hospital (Specify)

Out Patient (Specify)

Number of Working Days Applied for:
Inclusive Dates: Commutation:
Requested Not Requested

Printed Name & Signature of Applicant

8 CERTIFICATION OF LEAVE CREDITS 9. Recommendations:

as of Approval Disapproval

Vacation Sick Total

DIOLERIANO Y. CACAIT, JR.

School Head

EDITA S. CANO TERESA D. VILLA

Administrative Officer V Public School District Supervisor

10 Approved for: 11. Disapproved due to:

days with pay

days without pay
others (specify)
Date:

MOISES D. LABIAN, JR., Ph. D. CESE

Assistant Schools Division Superintendent

SPECIAL ORDER Date

No.

The application for days of leave of absence

with/without pay on ,of, permanent
national teacher of , Calbayog City is hereby approved.
This established a service credit balance of days which may be used to offset future absences
due to illness.
By Authority of the DepEd Regional Director

Copy Furnished

Concerned
Division Office File MOISES D. LABIAN, JR., Ph. D. CESE
Office File Assistant Schools Division Superintendent
 CSC Form No. 6
(For School Heads)

1 Office Agency: 2 Name (Last) (First) (MI)

DepEd - CARAYMAN NATIONAL HIGH SCHOOL DIMAKILING IRENE A.
3 Date of Filing: 4 Position: 5 Salary (Monthly)
April 24, 2019 HEAD TEACHER I Php 26494.00
6 Type of Leave: 7 Where Leave will be spent:
Vacation In case of Vacation Leave
To seek employment Within the Philippines
Sick Abroad (Specify)
Maternity
Others (Specify) In case of Sick Leave
Forced Leave In Hospital (Specify)

Out Patient (Specify)

Number of Working Days Applied for: 2 days
Inclusive Dates: April 25-26, 2019 Commutation:
Requested Not Requested

IRENE A. DIMAKILING
Printed Name & Signature of Applicant

8 CERTIFICATION OF LEAVE CREDITS 9. Recommendations:

as of Approval Disapproval

Vacation Sick Total

TERESA D. VILLA
Public Schools District Supervisor
EDITA S. CANO
Administrative Officer V

10 Approved for: 11. Disapproved due to:

days with pay

days without pay
others (specify)
Date:

MOISES D. LABIAN, JR.,Ph.D., CESE

Assistant Schools Division Superintendent

SPECIAL ORDER Date

No.

The application for leave of absence with/without pay for the period of
Mr./Mrs./Ms. of Calbayog City
Name Designation

Division is hereby approved/disapproved in accordance with Executive Order No. 284 dated January 19, 1971. Same are
being offset to his/her credits.
By Authority of the DepEd Regional Director

Copy Furnished

Concerned
Division Office File MOISES D. LABIAN, JR., Ph.D., CESE
Office File Assistant Schools Division Superintendent
 CSC Form No. 6
(For PSDS)

1 Office Agency: 2 Name (Last) (First) (MI)

DepEd -
3 Date of Filing: 4 Position: 5 Salary (Monthly)

6 Type of Leave: 7 Where Leave will be spent:

Vacation In case of Vacation Leave
To seek employment Within the Philippines
Sick Abroad (Specify)
Maternity
Others (Specify) In case of Sick Leave
In Hospital (Specify)

Out Patient (Specify)

Number of Working Days Applied for:
Inclusive Dates: Commutation:
Requested Not Requested

Printed Name & Signature of Applicant

8 CERTIFICATION OF LEAVE CREDITS 9. Recommendations:

as of Approval Disapproval

Vacation Sick Total

RENATO S. CAGOMOC, Ed. D.

EDITA S. CANO CID Chief
Administrative Officer V

10 Approved for: 11. Disapproved due to:

days with pay

days without pay
others (specify)
Date:

MOISES D. LABIAN, JR.,Ph.D., CESE

Assistant Schools Division Superintendent

SPECIAL ORDER Date

No.

The application for leave of absence with/without pay for the period of
Mr./Mrs./Ms. of Calbayog City
Name Designation

Division is hereby approved/disapproved in accordance with Executive Order No. 284 dated January 19, 1971. Same are
being offset to his/her credits.
By Authority of the DepEd Regional Director

Copy Furnished

Concerned
Division Office File MOISES D. LABIAN, JR., Ph.D., CESE
Office File Assistant Schools Division Superintendent
 CSC Form No. 6
(For School Staff)

1 Office Agency: 2 Name (Last) (First) (MI)

DepEd -
3 Date of Filing: 4 Position: 5 Salary (Monthly)

6 Type of Leave: 7 Where Leave will be spent:

Vacation In case of Vacation Leave
To seek employment Within the Philippines
Sick Abroad (Specify)
Maternity
Others (Specify) In case of Sick Leave
In Hospital (Specify)

Out Patient (Specify)

Number of Working Days Applied for:
Inclusive Dates: Commutation:
Requested Not Requested

Printed Name & Signature of Applicant

8 CERTIFICATION OF LEAVE CREDITS 9. Recommendations:

as of Approval Disapproval

Vacation Sick Total

School Head

EDITA S. CANO
Administrative Officer V Public School District Supervisor

10 Approved for: 11. Disapproved due to:

days with pay

days without pay
others (specify)
Date:

MOISES D. LABIAN, JR.,Ph.D., CESE

Assistant Schools Division Superintendent

SPECIAL ORDER Date

No.

The application for leave of absence with/without pay for the period of
Mr./Mrs./Ms. of Calbayog City
Name Designation

Division is hereby approved/disapproved in accordance with Executive Order No. 284 dated January 19, 1971. Same are
being offset to his/her credits.
By Authority of the DepEd Regional Director

Copy Furnished

Concerned
Division Office File MOISES D. LABIAN, JR., Ph.D., CESE
Office File Assistant Schools Division Superintendent