CSC FORM NO.

06
REVISED 1994
OFFICE/AGENCY NAME: LAST FIRST MIDDLE
OFFICE OF THE SANGGUNIANG BAYAN BOCAGO CARLITO A.
DATE OF FILING POSITION SALARY (MONTHLY)
July 3, 2017 SB MEMBER P 42,981.00

DETAILS OF APPLICANT
TYPE OF LEAVE: WHERE LEAVE WILL BE SPENT
IN CASE OF VACATION LEAVE
/ / VACATION LEAVE / / WITHIN THE PHILIPPINES
/ / TO SEEK EMPLOYMENT / / ABROAD (SPECIFY)
/ X / OTHERS
FORCED LEAVE IN CASE OF SICK LEAVE

/ /SICK / / IN HOSPITAL (SPECIFY)

/ / MATERNITY / / OUT PATIENT (SPECIFY)
/ / OTHERS
COMMUTATION

NUMBER OF WORKING DAYS APPLIED FOR: / / REQUESTED / / NOT REQUESTED

1-day

INCLUSIVE DATE:

July 4, 2017 CARLITO A. BOCAGO

SIGNATURE OF APPLICANT
CERTIFICATION OF LEAVE CREDITS AS OF: RECOMMENDATION:

/ / APPROVED
VACATION SICK TOTAL / / DISAPPROVED

DAYS DAYS DAYS

AILEEN N. GAYANILO
Administrative Assistant II
HRMO-Designate

Authorized Official
APPROVED FOR: DISAPPROVED DUE TO:
DAYS WITH PAY
DAYS WITHOUT PAY
DAYS (SPECIFY)

APPROVED:

BAYANI B. VELUZ
Municipal Vice Mayor
Date:
1. Application for vacation or sick leave for one full day or more shall be made in this form to be at
least quadruplicate.
2. Application for vacation leave shall be filed in advance or whenever possible (5) days before
going 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 consultation was not availed of an affidavit should be
executed by applicant.
4. An employee who is absent without approved leave shall not to received his salary
corresponding to the period of his authorized leave of absence.
5.
CSC FORM NO. 06
REVISED 1994
OFFICE/AGENCY NAME : LAST FIRST MIDDLE
OFFICE OF THE VICE MAYOR GARCIA ANNA MARIE DEL GALLEGO
DATE OF FILING POSITION SALARY (MONTHLY)
May 2, 2017 Administrative Aide I P 8,639.00

DETAILS OF APPLICANT
TYPE OF LEAVE: WHERE LEAVE WILL BE SPENT
IN CASE OF VACATION LEAVE
/ / VACATION LEAVE / / WITHIN THE PHILIPPINES
/ / TO SEEK EMPLOYMENT / / ABROAD (SPECIFY)
/ / OTHERS
IN CASE OF SICK LEAVE

/ X / SICK / / IN HOSPITAL (SPECIFY)

/ / MATERNITY / / OUT PATIENT (SPECIFY)
/ / OTHERS - SICK LEAVE
COMMUTATION

NUMBER OF WORKING DAYS APPLIED FOR: / / REQUESTED / / NOT REQUESTED

2 day

INCLUSIVE DATE:

April 20,26 2017 ANNA MARIE D. GARCIA

SIGNATURE OF APPLICANT
CERTIFICATION OF LEAVE CREDITS AS OF: RECOMMENDATION:

/ / APPROVED
VACATION SICK TOTAL / / DISAPPROVED

DAYS DAYS DAYS

AILEEN N. GAYANILO
Administrative Assistant II
HRMO-Designate

Authorized Official
APPROVED FOR: DISAPPROVED DUE TO:
Two (2) DAYS WITH PAY
DAYS WITHOUT PAY
DAYS (SPECIFY)

APPROVED:

BAYANI B. VELUZ
Municipal Vice Mayor
Date:
1. Application for vacation or sick leave for one full day or more shall be made in this form to be at
least quadruplicate.
2. Application for vacation leave shall be filed in advance or whenever possible (5) days before
going 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 consultation was not availed of an affidavit should be
executed by applicant.
4. An employee who is absent without approved leave shall not to received his salary
corresponding to the period of his authorized leave of absence.
5.
CSC FORM NO. 06
REVISED 1994
OFFICE/AGENCY NAME : LAST FIRST MIDDLE
OFFICE OF THE MUNICIPAL VICE MAYOR RAFA JOEY COLLANTES
DATE OF FILING POSITION SALARY (MONTHLY)
June 1, 2016 Administrative Aide I P 6,750.00

DETAILS OF APPLICANT
TYPE OF LEAVE: WHERE LEAVE WILL BE SPENT
IN CASE OF VACATION LEAVE
/ / VACATION LEAVE / / WITHIN THE PHILIPPINES
/ / TO SEEK EMPLOYMENT / / ABROAD (SPECIFY)
/ X / OTHERS Sick Leave
IN CASE OF SICK LEAVE

/ / SICK / / IN HOSPITAL (SPECIFY)

/ / MATERNITY / / OUT PATIENT (SPECIFY)
/ / OTHERS
COMMUTATION

NUMBER OF WORKING DAYS APPLIED FOR: / / REQUESTED / / NOT REQUESTED

ONE(1) working day

INCLUSIVE DATE:

May 19, 2016 JOEY C. RAFA

SIGNATURE OF APPLICANT
CERTIFICATION OF LEAVE CREDITS AS OF: RECOMMENDATION:

/ / APPROVED
VACATION SICK TOTAL / / DISAPPROVED

DAYS DAYS DAYS

AILEEN N. GAYANILO
Administrative Assistant II
HRMO-Designate

Authorized Official
APPROVED FOR: DISAPPROVED DUE TO:
One(1) DAYS WITH PAY
DAYS WITHOUT PAY
DAYS (SPECIFY)

APPROVED:

ALLAN I. VILLAREAL
Municipal Vice Mayor
Date:
1. Application for vacation or sick leave for one full day or more shall be made in this form to be at
least quadruplicate.
2. Application for vacation leave shall be filed in advance or whenever possible (5) days before
going 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 consultation was not availed of an affidavit should be
executed by applicant.
4. An employee who is absent without approved leave shall not to received his salary
corresponding to the period of his authorized leave of absence.
5.
CSC FORM NO. 06
REVISED 1994
OFFICE/AGENCY NAME : LAST FIRST MIDDLE
OFFICE OF THE MUNICIPAL VICE MAYOR MALACAD ROWENA TALLADA
DATE OF FILING POSITION SALARY (MONTHLY)
MARCH 27, 2015 Administrative Aide I P 6,750.00

DETAILS OF APPLICANT
TYPE OF LEAVE: WHERE LEAVE WILL BE SPENT
IN CASE OF VACATION LEAVE
/ / VACATION LEAVE / / WITHIN THE PHILIPPINES
/ / TO SEEK EMPLOYMENT / / ABROAD (SPECIFY)
/X / OTHERS
FORCED LEAVE IN CASE OF SICK LEAVE

/ / SICK / / IN HOSPITAL (SPECIFY)

/ / MATERNITY / / OUT PATIENT (SPECIFY)
/ / OTHERS
COMMUTATION

NUMBER OF WORKING DAYS APPLIED FOR: / / REQUESTED / / NOT REQUESTED

Three (3) days

INCLUSIVE DATE:

March 31, April 1 & 6, 2015 ROWENA T. MALACAD

SIGNATURE OF APPLICANT
CERTIFICATION OF LEAVE CREDITS AS OF: RECOMMENDATION:

/ / APPROVED
VACATION SICK TOTAL / / DISAPPROVED

DAYS DAYS DAYS

AILEEN N. GAYANILO
Administrative Assistant II
HRMO-Designate

Authorized Official
APPROVED FOR: DISAPPROVED DUE TO:
DAYS WITH PAY
DAYS WITHOUT PAY
DAYS (SPECIFY)

APPROVED:

ALLAN I. VILLAREAL
Municipal Vice Mayor
Date:
1. Application for vacation or sick leave for one full day or more shall be made in this form to be at
least quadruplicate.
2. Application for vacation leave shall be filed in advance or whenever possible (5) days before
going 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 consultation was not availed of an affidavit should be
executed by applicant.
4. An employee who is absent without approved leave shall not to received his salary
corresponding to the period of his authorized leave of absence.
5.

CSC FORM NO. 06

REVISED 1994
OFFICE/AGENCY NAME : LAST FIRST MIDDLE
OFFICE OF THE SB MEMBER TERRENAL EDUARDO R.
DATE OF FILING POSITION SALARY (MONTHLY)
Feb. 14, 2017 ABC President P 37,313.00

DETAILS OF APPLICANT
TYPE OF LEAVE: WHERE LEAVE WILL BE SPENT
IN CASE OF VACATION LEAVE
/ / VACATION LEAVE / / WITHIN THE PHILIPPINES
/ / TO SEEK EMPLOYMENT / / ABROAD (SPECIFY)
/ X / OTHERS
Forced Leave IN CASE OF SICK LEAVE

/ / SICK / / IN HOSPITAL (SPECIFY)

/ / MATERNITY / / OUT PATIENT (SPECIFY)
/ / OTHERS
COMMUTATION

NUMBER OF WORKING DAYS APPLIED FOR: / / REQUESTED / / NOT REQUESTED

1 day

INCLUSIVE DATE:

February 14, 2017 HON. EDUARDO R. TERRENAL

SIGNATURE OF APPLICANT
CERTIFICATION OF LEAVE CREDITS AS OF: RECOMMENDATION:

/ / APPROVED
VACATION SICK TOTAL / / DISAPPROVED

DAYS DAYS DAYS

AILEEN N. GAYANILO
Administrative Assistant II
HRMO-Designate

Authorized Official
APPROVED FOR: DISAPPROVED DUE TO:
DAYS WITH PAY
DAYS WITHOUT PAY
DAYS (SPECIFY)

APPROVED:

BAYANI B. VELUZ
Municipal Vice Mayor
Date:
1. Application for vacation or sick leave for one full day or more shall be made in this form to be at
least quadruplicate.
2. Application for vacation leave shall be filed in advance or whenever possible (5) days before
going 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 consultation was not availed of an affidavit should be
executed by applicant.
4. An employee who is absent without approved leave shall not to received his salary
corresponding to the period of his authorized leave of absence.
5.