CSC Form 6

Revised 1998
APPLICATION FOR LEAVE
1. Office/Agency 2. Name (Last) (First) (Middle)
Sta. Catalina INHS
3. Date of Filing 4. Position 5. Salary
14-Aug-19 TEACHER III PhP 25,232.00
DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave

Maternity In hospital (Specify)
ü Others (Specify)

6. C) Number of Working Days applied for: 6. D) Commutation

1 DAY Requested Not Requested
Inclusive Dates
15-Aug-19
Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A) Certification of Leave Credits 7. B) Recommendation:
as o

Vacation Sick Total Approval

Disapproval due to
days days days

NENITA B. EVASCO
Authorized Official Principal III

7. C) Approved for: 7. D) Disapproved due to:

days with pay
days without pay

EDGARDO B. MILITANTE
Assistant Schools Division Superintendent
Date: _________________

Note:
1. Application for vacation or sick leave for one full day or more shall be made on this form to be
accomplished at least in duplicate
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before
going on such leave.
3. Application for sick leave filed in advance or exceeding five (5) days shall be accompanied by a
medical certificate. In case of medical certificate was not availed or an affidavit should be executed by
the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive his salary
corresponding to the period of his unauthoried leave of absence.
5. An application for leave of absence of thirty (30) calendar days or more shall accompanied by a
clearance from money and property accountability.
 POSITION SALARY
TEACHER I ###
TEACHER II ###
TEACHER III ###
MASTER TEACHER I ###
MASTER TEACHER II ###
HEAD TEACHER I ###
PRINCIPAL III ###
ASSISTANT PRINCIPAL II ###
ADMINISTRATIVE ASSISTANT II ###
REGISTRAR ###
SENIOR BOOKKEEPER ###
DISBURSING OFFICER ###