CSC Form No.

6
Revised 1984

APPLICATION FOR LEAVE

(TRAVEL ABROAD)
1.) Office/Agency: 2.) Name:
Dep-ED
ANTONINO BERNARDO DE BELEN
SAN ISIDRO DISTRICT
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:

August 24, 2018 SCHOOL PRINCIPAL II 60,491.00

DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) BANGKOK
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: 4 DAYS _____ Requested _____ Not Requested

Inclusive Dates: OCTOBER 13-16, 2018

BERNARDO B. ANTONINO
(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) Certification of Leave Credits: 7 b.) Recommendation:

As of: ____________________________________________

VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________

Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________

REYMO R. ALDAMA GINA G. ABESAMIS

Administrative Officer IV Public Schools District Supervisor

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

________ Day/s with Pay

________ Day/s without pay
________ Other/s (specify)

RONALDO A. POZON, Ph.D.,CESO V BEATRIZ G. TORNO,Ph.D., CESO V

Schools Division Superintendent Regional Director DepEd, Central Office

GUIDELINES ON THE FILING OF APPLICATION

FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)

INSTRUCTIONS

1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and 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 accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
 CSC Form No. 6
Revised 1984

APPLICATION FOR LEAVE

1.) Office/Agency: 2.) Name:
Dep-ED
BERMISA
KAPT. PEDRO VILLANUEVA ES/ PENARANDA DISTRICT
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:

DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested

Inclusive Dates:

(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) Certification of Leave Credits: 7 b.) Recommendation:

As of: ____________________________________________

VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________

Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________

REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

________ Day/s with Pay

________ Day/s without pay
________ Other/s (specify)

ORLANDO C. DE LEON
Administrative Officer V

GUIDELINES ON THE FILING OF APPLICATION

FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)

INSTRUCTIONS

1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and 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 accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
CSC Form No. 6
Revised 1984

APPLICATION FOR LEAVE

1.) Office/Agency: 2.) Name:
Dep-ED

(Last Name) (Given Name) (Middle Name)

3.) Date of Filing: 4.) Position: 5.) Salary/Month:
P

DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested

Inclusive Dates:

(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) Certification of Leave Credits: 7 b.) Recommendation:

As of: ____________________________________________

VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________

Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________

REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

________ Day/s with Pay

________ Day/s without pay
________ Other/s (specify)

JOHANNA N. GERVACIO, Ph. D.

Asst. Schools Division Superintendent

GUIDELINES ON THE FILING OF APPLICATION

FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)

INSTRUCTIONS

1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and 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 accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.

CSC Form No. 6

Revised 1984

APPLICATION FOR LEAVE

1.) Office/Agency: 2.) Name:
Dep-ED

(Last Name) (Given Name) (Middle Name)

3.) Date of Filing: 4.) Position: 5.) Salary/Month:

DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) __________________________ Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: _____ Requested _____ Not Requested

Inclusive Dates:

(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) Certification of Leave Credits: 7 b.) Recommendation:
As of: ____________________________________________

VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________

Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________

REYMO R. ALDAMA
Administrative Officer IV PSDS/School Principal

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

Days with Pay

Days without pay
Others (specify)

ERICSON S. SABACAN, Ed. D.

Asst. Schools Division Superintendent

GUIDELINES ON THE FILING OF APPLICATION

FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)

INSTRUCTIONS

1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and 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 accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
CSC Form No. 6
Revised 1984

APPLICATION FOR LEAVE

1.) Office/Agency: 2.) Name:
Dep-ED
BUSUEGO RUTH VILLANUEVA
SAN ISIDRO DISTRICT
(Last Name) (Given Name) (Middle Name)
3.) Date of Filing: 4.) Position: 5.) Salary/Month:

August 30, 2018 TEACHER I 21,231.00

DETAILS OF APPLICATION
6 a.) Type of Application: 6 b.) Where leave will be spent:
Vacation Leave: 1.) Incase of Vacation Leave
To seek employment __________________________ Within the Philippines _________________________
Others (specify) Abroad (Specify) _________________________
Sick Leave: 2.) Incase of Sick Leave
Maternity __________________________ InHospital (specify) _________________________
Others (specify) SICK LEAVE Out-Patient (specify) _________________________
6 c.) Number of Working Days: 6 d.) Commutation:
Applied for: 60 Days _____ Requested _____ Not Requested

Inclusive Dates: September 6, 2018 to November 4, 2018

RUTH V. BUSUEGO
(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) Certification of Leave Credits: 7 b.) Recommendation:

As of: ____________________________________________

VACATION (DAYS) SICK (DAYS) TOTAL (DAYS) Approved: ___________________________________

Disapproved due to: ___________________________________
______________ ______________ _______________ ___________________________________

ALFREDO G. ESPINOZA
School Principal II

REYMO R. ALDAMA GINA G. ABESAMIS

Administrative Officer IV PSDS/School Principal

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

________ Day/s with Pay

________ Day/s without pay
________ Other/s (specify)

RONALDO A. POZON, Ph. D., CESO V

Schools Division Superintendent

GUIDELINES ON THE FILING OF APPLICATION

FOR VACATION LEAVE OF ABSENCE
(MECS ORDER No. 26, s. 1985)

INSTRUCTIONS

1. Application for vacation or sick Leave for one (1) full day or more shall be made on this Form and 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 accomplished by a medical certificate. In case
medical consultation was not availed of, an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive salary corresponding to the period of his
unauthorized leave of absence.
5. An application for leave of absence for thirty (30) calendar days or more shall be accomplished by a clearance from money
and property accountabilities.
rra.
NOTE: 10 DAYS & BELOW,, AO V
11-29 DAYS, ASDS
30 & above, SUPT.
CSC Form No. 6
APPLICATION FOR LEAVE
1.) Office/Agency: 2.) Name:
Dep-ED

(Last ) (First) (Middle)

3.) Date of Filing: 4.) Position: 5.) Salary/Month:

DETAILS OF APPLICATION
6 a.) TYPE OF LEAVE: 6 b.) WHERE LEAVE WILL BE SPENT:

_____ Vacation Leave 1.) IN CASE OF VACATION LEAVE:

_____ To seek employment Within the Philippines _________________________

____ Others (specify) Abroad (Specify) _________________________

MONETIZATION OF LEAVE CREDITS (MOLC)

_____ Sick Leave 2.) IN CASE OF SICK LEAVE:

_____ Maternity InHospital (specify) _________________________

_____ Others Out-Patient (specify) _________________________

6 c.) NUMBER OF WORKING DAYS; 6 d.) COMMUTATION:

APPLIED FOR: Days __/___ Requested _____ Not Requested

INCLUSIVE DAY/S:

(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7 a.) CERTIFICATION OF LEAVE CREDITS: 7 b.) RECOMMENDATION:

As of:

VACATION SICK TOTAL

_____ APPROVED
_____ DISAPPROVED due to:

vvvvvvvv vvvvvvvv vvvvvvvv PSDS/School Principal

REYMO R. ALDAMA ORLANDO C. DE LEON

Administrative Officer IV Administrative Officer V

7 c.) APPROVED FOR: 7 d.) DISAPPROVED DUE TO:

Day/s with Pay

________ Day/s without pay
________ Other/s (specify)

RONALDO A. POZON, Ph. D., CESO V

Schools Division Superintendent
rra.