CSCFORM NO.

6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Health Office TAN ELSA QUINTO
3. Date of Filing 4. POSITION 5. SALARY
JULY 2, 2019 NURSE III P 39,77400/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Terminal Leave Benefit _______ _______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
____ Terminal Leave Benefit_ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____300.591______Days ( ) Requested

INCLUSIVE DATES: __ ________ __

_____Elsa Q. Tan ____

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ June 4, 2019__ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
95.258 : 205.333 : 300.591
================================ ELEANOR MAY D. GRATE, M.D.
Days Days Days Municipal Health Office
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR: 7. D DISAPPROVED DUE TO:
____ _ Days with pay ___________________________________________
________Days without pay ___________________________________________
_300.591 Others (Terminal Leave Benefits) ___________________________________________

______________________________________
(Signature)
HON. NANCY CASTRO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
 APPLICATION FOR LEAVE

Statement of Leave Credits

Vacation Leave Sick Leave

Days Days

Balance as of June 4, 2019 98.258 205.333

Less: Terminal Leave Benefits 98.258 205.333
Balance as of June 4, 2019 0.000 0.000

Certified Correct:

PHOEBE JOY D. BARRAMEDA

Acting HRMO / SB Secretary
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Treasurer’s Office PERLAS ROSELLINE F.
3. Date of Filing 4. POSITION 5. SALARY
December 24, 2018 Asst. Municipal Treasurer P51, 428/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ __________________ _______ _______________ ______________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____2.000______Days ( ) Requested

INCLUSIVE DATES: __ December 27-28, 2018 __

_ _ROSELLINE F. PERLAS __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ November 30, 2018 ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
81.596 : 267.200 : 348.796
================================ HON. RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR: 7. D DISAPPROVED DUE TO:
2.000__Days with pay ___________________________________________
________Days without pay ___________________________________________
_ _____ Others (SPL) ___________________________________________

______________________________________
(Signature)
HON. RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Legislative Office PERLAS EDGAR RECAÑA
3. Date of Filing 4. POSITION 5. SALARY
October 5, 2018 Former Liga Federation President P55,798.00/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Terminal Leave Benefit _______ _______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
____ Terminal Leave Benefit_ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____126.916______Days ( ) Requested

INCLUSIVE DATES: __ ________ __

_ _EDGAR R. PERLAS __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ June 30, 2019__ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
58.458 : 68.458 : 126.916
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR: 7. D DISAPPROVED DUE TO:
____ _ Days with pay ___________________________________________
________Days without pay ___________________________________________
_126.916 Others (Terminal Leave Benefit) ___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Health Office ISRAEL MAJALALEL MATINING
3. Date of Filing 4. POSITION 5. SALARY
February 6, 2018 Rural Sanitation Inspector P14,340.00/month
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ __________________________ ________________ ______________________
( X ) Sick (2) In case of SICK LEAVE
( X ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____60.000______Days ( ) Requested

INCLUSIVE DATES: __ February 15 - April 16, 2018 __

_ _MAJALALEL M. ISRAEL __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
20.973 : 6.417 : 27.390
================================ DR. ELEANOR MAY D. GRATE
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
______ Days with pay
_________Days without pay
_60.000 Others (Maternity Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Civil Registrar’s Office MILAMBILING UJUNNEIL VIDA
3. Date of Filing 4. POSITION 5. SALARY
November 16, 2017 Municipal Civil Registrar P 51,702.75/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ __________________ _______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____2.000______Days ( ) Requested

INCLUSIVE DATES: __November 17 & 20, 2017________

_ _UJUNNEIL V. MILAMBILING __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ October 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
11.903 : 31.317 : 43.220
================================ FLORENTINO B. PINAROC
Days Days Days OIC - Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
2.000 Days with pay
________Days without pay
______ Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
OIC - Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Health Office Reassigned OBSEQUIO MARIDEN LINING
3. Date of Filing 4. POSITION 5. SALARY
November 20, 2017 Const. & Maint. Man P 7,764.00/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Monetization ________ _______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____15.000______Days ( ) Requested

INCLUSIVE DATES: __Monetization________

_ _MARIDEN L. OBSEQUIO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ October 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
20.105 : 13.397 : 33.502
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
_____ Days with pay
________Days without pay
15.000 Others (Monetization)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Assessor’s Office Reassigned FERANGCO ASISCLO SADIWA
3. Date of Filing 4. POSITION 5. SALARY
November 10, 2017 Administrative Aide I P 7,485.75/month
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Forced Leave _______
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ ___________________ _____
6. C Number of Working Days/Applied
For _____5.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __November 13-17, 2017__ _________

_ _ASISCLO S. FERANGCO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ September 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
26.417 : 24.417 : 50.834
================================ BERT S. FABRERO
Days Days Days Municipal Assessor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_____ Days with pay
________Days without pay
_5.000 Others (Forced Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

3. Date of Filing 4. POSITION 5. SALARY

6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( ) Others
_ ___________________________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ ___________________ _____
6. C Number of Working Days/Applied
For ___________Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: ____ _________

_ ______________-______
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ ______________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
: :
================================ NANCY CASTRO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
_____Days with pay
________Days without pay
_____ Others (Please Specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
NANCY CASTRO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

Statement of Leave Credits

Vacation Leave Sick Leave

Days Days

Balance as of ____________ ______ _______

Less: __________________ _____ _____
Balance as of ___________ ______ _______

Certified Correct:

PHOEBE JOY D. BARRAMEDA

Acting HRMO / SB Secretary
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Assessor’s Office SALVACION ELOISA LUNDAG
3. Date of Filing 4. POSITION 5. SALARY
September 25, 2018 Assessment Clerk I P 9,986.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ ___________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____2.000______Days ( ) Requested

INCLUSIVE DATES: __September 6 & 24, 2018__ _________

_ _ELOISA L. SALVACION __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ August 31, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
14.714 : 11.093 : 25.807
================================ ENGR. BERT S. FABRERO
Days Days Days Municipal Assessor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
2.000_Days with pay
________Days without pay
_____ Others (Please Specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

Statement of Leave Credits

Vacation Leave Sick Leave

Days Days

Balance as of August 31, 2018 14.714 11.093

Less: September 6 & 24, 2018 SL 0.000 2.000
Balance as of August 31, 2018 14.714 9.042

Certified Correct:

PHOEBE JOY D. BARRAMEDA

Acting HRMO / SB Secretary
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office LACDAO RICHARD EVANGELISTA
3. Date of Filing 4. POSITION 5. SALARY
August 1, 2017 Administrative Aide I P 7,485.75
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ _________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____11.000______Days ( ) Requested

INCLUSIVE DATES: __July 6-7,11-14 & 17-21, 2017__ _________

_ _RICHARD E. LACDAO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ June 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
19.417 : 27.417 : 46.834
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
11.000 Days with pay
________Days without pay
_______ Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Assessor’s Office SALVACION ELOISA LUNDAG
3. Date of Filing 4. POSITION 5. SALARY
March 8, 2018 Assessment Clerk I P 9,610.50
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ _________________________ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____2.000______Days ( ) Requested

INCLUSIVE DATES: __March 15-16, 2018__ _________

_ _ELOISA L. SALVACION __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ September 30 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
7.266 : 7.592 : 14.858
================================ BERT S. FABRERO
Days Days Days Municipal Assessor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
2 .000 Days with pay
________Days without pay
_______ Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office ROQUEZA ENRICO ABLING
3. Date of Filing 4. POSITION 5. SALARY
June 7, 2017 Construction & Maint. Man P 8,000.25
6. Type of Leave 6.B Where leave will be spent

( x ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ Special Privilege Leave_______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______1.000______Days ( ) Requested

INCLUSIVE DATES: __June 13, 2017__ _________

_ _ENRICO A. ROQUEZA __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
10.744 : 11.083 : 21.287
================================ Engr. RAMON A. QUEJANO
Days Days Days Municipal Engineer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
_______Days with pay ___________________________________________
________Days without pay ___________________________________________
__1.000 Others (SPL) ___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Acting Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office SALVACION JORGE PADILLA
3. Date of Filing 4. POSITION 5. SALARY
May 8, 2017 License Inspector I P 11,048.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Terminal Leave Benefit_______ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
_____ Terminal Leave Benefit _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______199.780______Days ( ) Requested

INCLUSIVE DATES: __Terminal Leave Benefit__ _________

___JORGE P. SALVACION __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ April 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
28.466 : 171.314 : 199.780
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
_______Days with pay ___________________________________________
________Days without pay ___________________________________________
199.780 Others (TLB) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

11. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
12. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
13. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
14. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
15. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

M. S. W. D. O. SADIWA MARIA TERESITA GRAVE
3. Date of Filing 4. POSITION 5. SALARY
January 29, 2017 Social Welfare Assistant P 12, 677.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

___MARIA TERESITA G. SADIWA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ December 31, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
40.721 : 136.146 : 176.867
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

16. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
17. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
18. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
19. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
20. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office ROCHA VIRGILIO LOGMAO
3. Date of Filing 4. POSITION 5. SALARY
December 27, 2018 Former Admin Aide III P 9,311.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Terminal Leave Benefit
( X ) Sick
( ) Maternity
( X ) Others (Specify)
_____ _______________
6. C Number of Working Days/Applied
For ______37.077______Days
( ) within the Philippines
( ) Abroad (Specify)
_____ ______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
______ ( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __Terminal Leave Benefit___

___ VIRGILIO L. ROCHA__ __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 31, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
24.932 : 12.145 : 37.077
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

SORPRESA G. SADIWA
HRM Aide
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
_______ Days with pay ___________________________________________
________Days without pay ___________________________________________
_37.077_ Others (TLB) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office SADIWA EDEN SEVILLA
3. Date of Filing 4. POSITION 5. SALARY
April 24, 2017 Construction & Maintenance Man P 8,214.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ MONETIZATION______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______15.000______Days ( ) Requested

INCLUSIVE DATES: __15-Days Monetization _

___ EDEN S. SADIWA__ __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ March 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
48.373 : 180.132 : 228.505
================================ FLORENTINO B. PINAROC
Days Days Days Acting Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
______ _Days with pay ___________________________________________
________Days without pay ___________________________________________
_15.000_Others (Monetization) ___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
Acting Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office NAVISA ERNESTO DEL MUNDO
3. Date of Filing 4. POSITION 5. SALARY
February 8, 2019 Cemetery Caretaker I P 9,305.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Forced Leave ____________ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______5.000______Days ( ) Requested

INCLUSIVE DATES: __February 11-15, 2019 _

___ ERNESTO D. NAVISA__ __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31,2019________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
41.243 : 229.420 : 273.663
================================ RAMON A. QUEJANO
Days Days Days Municipal Engineer
(Head of Office)

SORPRESA G. SADIWA
LDRRM Assistant / Reassigned HRM Aide
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
___5 __Days with pay ___________________________________________
________Days without pay ___________________________________________
________Others (Please specify) ___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
OIC - Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office SAEZ ELDEN PRIVADO
3. Date of Filing 4. POSITION 5. SALARY
December 20, 2017 Administrative Aide IV P 9,443.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Forced Leave ____________ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______5.000______Days ( ) Requested

INCLUSIVE DATES: __December 21-22, 27-29, 2017 __ _________

_____ ELDEN P. SAEZ____ __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Novemebr 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================

================================ RAMON A. QUEJANO

Days Days Days Municipal Engineer
(Immediate Supervisor)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
___ ___Days with pay
________Days without pay
_5.000__Others (Forced Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

M. S. W. D. O. SADIWA MARIA TERESITA GRAVE
3. Date of Filing 4. POSITION 5. SALARY
January 29, 2017 Social Welfare Assistant P 12, 677.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

___MARIA TERESITA G. SADIWA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ December 31, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
40.721 : 136.146 : 176.867
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

M. S. W. D. O. SADIWA MARIA TERESITA GRAVE
3. Date of Filing 4. POSITION 5. SALARY
January 29, 2017 Social Welfare Assistant P 12, 677.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

___MARIA TERESITA G. SADIWA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ December 31, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
40.721 : 136.146 : 176.867
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

6. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
7. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
8. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
9. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
10. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Engineering Office QUEJANO RAMON ALBRANDO
3. Date of Filing 4. POSITION 5. SALARY
October 2, 2017 Municipal Engineer P 53, 124.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ __________ ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______2.000______Day

s ( ) Requested

INCLUSIVE DATES: __August 29-30, 2017__ _________

__RAMON A. QUEJANO __
(Signature of Applicant)

DETAILS OF ACTION APPLICATION

7. A Certification of Leave Credits
7.B Recommendation
As of ___ July 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
53.272 : 88.584 : 141.856
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary

7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:

_2.000 _Days with pay ___________________________________________
________Days without pay ___________________________________________
________Others (Please Specify) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Sanguniang Bayan Legislative Office REANZARES VIOLETA PIELAGO
3. Date of Filing 4. POSITION 5. SALARY
January 8, 2018 Administrative Aide IV P 10,068.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( ) Others
_ _________________________
(X) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______9.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
(x) In hospital (Specify)
____Dr. Damian Reyes Provincial Hospital____
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __December 12-15 & 18-22, 2017__ _________

___ VIOLETA P. REANZARES __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ November 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
4.130 : 16.178 : 20.308
================================ PHOEBE JOY D. BARRAMEDA
Days Days Days SB Secretary
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
9.000_ Days with pay
________Days without pay
________Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Sanguniang Bayan Secretariat Office BARRAMEDA PHOEBE JOY DUSABAN
3. Date of Filing 4. POSITION 5. SALARY
February 6, 2019 SB Secretary P 63,575.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ __________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) __________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______63.000______Days ( ) Requested

INCLUSIVE DATES: February 11-15, 18-22, 26-28, March 1,4-8,11-15,18-22,25-29,

April 1-5,8,10-12,15-17,22-26,29-30, May 2-3,6-10,13-15, 2019__

__ PHOEBE JOY D. BARRAMEDA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31, 2019______ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
13.684 : 29.000 : 42.684
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

SORPRESA G. SADIWA
LDRRM Assistant/ HRM Aide
7. C APPROVED FOR: 7. D DISAPPROVED DUE TO:
42.000 Days with pay ___________________________________________
21.000 Days without pay ___________________________________________
_______ _Others (Please specify) ___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Health Office – Re-Ass. LAZO LORENA MALING
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Const & Maint. Man P 8,433.75
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

__ LORENA M. LAZO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Febuary 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
110.804 : 198.750 : 309.554
================================ ELEANOR MAY D. GRATE, MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Health Office SALVACION ELENA AREVALO
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Midwife II P 21,307.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

_ ELENA A. SALVACION __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Febuary 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
148.599 : 252.100 : 400.699
================================ ELEANOR MAY D. GRATE, MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE – CANCELLED MONETIZATION

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Health Office VALENZUELA NIDA BALENDO
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Midwife II P 21,777.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Terminal Leave Benefit______ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
_ Terminal Leave Benefit______ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______190.323______Days ( ) Requested

INCLUSIVE DATES: ___________ _________

__ NIDA B. VALENZUELA __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ October 2, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
75.154 : 115.169 : 190.323
================================ ELEANOR MAY D. GRATE, MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
______ _ Days with pay ___________________________________________
_____ ___Days without pay ___________________________________________
_190.323_Others (Terminal Leave Benefit) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Health Office TAN ELSA QUINTO
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Nurse III P 35,113.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

__ ELSA Q. TAN __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Febuary 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
94.425 : 173.500 : 267.925
================================ ELEANOR MAY D. GRATE, MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Health Office GRATE ELEANOR MAY DIAZ
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Municipal Health Officer 68,008.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

__ ELEANOR MAY D. GRATE, MD _

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Febuary 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
27.973 : 157.816 : 185.789
================================ FLORENTINO B. PINAROC
Days Days Days OIC - Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
OIC - Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Vice Mayor’s Office SIENA HANNILEE REY
3. Date of Filing 4. POSITION 5. SALARY
July 19, 2017 Municipal Vice Mayor P 53, 607.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
Forced Leave, Special Privilege Leave ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ________10 Days______________ ( ) Requested

INCLUSIVE DATES: __August 7-11,4-16, 17-18, 2017__ _________

___HANNILEE REY SIENA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ June 30, 2017_____________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
15.000 : 15.000 : 30.000
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
7.000 _ Days with pay ___________________________________________
________Days without pay ___________________________________________
_3.000 _Others (SPL) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Vice Mayor’s Office SIENA HANNILEE REY
3. Date of Filing 4. POSITION 5. SALARY
March 1, 2017 Municipal Vice Mayor P 53, 607.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ ___________ ____________ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ________13 Days______________ ( ) Requested

INCLUSIVE DATES: __May 3-5, 8-12, 15-19, 2017__ _________

___HANNILEE REY SIENA __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ February 28, 2017_____________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
10.000 : 10.000 : 20.000
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
__13 __Days with pay
________Days without pay
__ _ _Others (Others specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME ( LAST) (FIRST) (MIDDLE)

Municipal Treasurer’s Office GRAVE JULIANA SIENA
3. Date of Filing 4. POSITION 5. SALARY
February 27, 2017 Rev. Coll. Clerk I P 10,349.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______315.246______Days ( ) Requested

INCLUSIVE DATES: __315.246 Terminal Leave __ _________

___ JULIANA S. GRAVE __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ February 16, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
112.204 : 203.042 : 315.246
================================ ROSELLINE F. PERLAS
Days Days Days OIC – Municipal Treasurer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
315.246 _Others (Terminal Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME ( LAST) (FIRST) (MIDDLE)

Municipal Treasurer’s Office PERLAS ROSELLINE FRIAS
3. Date of Filing 4. POSITION 5. SALARY
June 8, 2018 Assistant Municipal Treasurer P 45,368.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Special Privilege Leave __ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______1.000______Days ( ) Requested

INCLUSIVE DATES: __June 11, 2018 __ __

___ ROSELLINE F. PERLAS __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 30, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
76.096 : 260.700 : 336.796
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_1.000 _Days with pay
________Days without pay
_ _Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Accounting Office Re-assigned RAMIREZ CARMELA SARMIENTO
3. Date of Filing 4. POSITION 5. SALARY
February 21, 2017 Administrative Aide VI P 10,760.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______10.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __10-Day Monetization__ _________

___CARMELA S. RAMIREZ __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
16.978 : 136.456 : 153.434
================================ ONOFRE S. SOTTO
Days Days Days Municipal Accountant
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__10.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Acting Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office FIEDALAN ANABELLE PELAEZ
3. Date of Filing 4. POSITION 5. SALARY
February 20, 2017 Administrative Aide I P 7,980.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

__ ANNABELLE P. FIEDALAN __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
26.235 : 10.059 : 36.294
================================ FLORENTINO B. PINAROC
Days Days Days OIC - Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
OIC - Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office MERCADO ROLLY SALVACION
3. Date of Filing 4. POSITION 5. SALARY
December 20, 2017 Administrative Aide IV P 10,068.00
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
(X) Others
_ FORCE LEAVE
(X) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______7.000______Days
( ) within the Philippines
( ) Abroad (Specify)
_ ______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __December 7, 8,11,12,13 & 14, 15, 2017__ _________

___ ROLLY S. MERCADO __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ NOVEMBER 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
52.880 : 238.250 : 291.130
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
_7.000 _Days with pay
________Days without pay
_______Others (please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office FIEDALAN RAMON GUEVARRA
3. Date of Filing 4. POSITION 5. SALARY
June 23, 2017 Administrative Aide III P 8,616.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______3.000______Days ( ) Requested

INCLUSIVE DATES: __June 19,20 & 21, 2017__ _________

___ ROLLY S. MERCADO __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
54.722 : 49.000 : 103.722
================================ FLORENTINO B. PINAROC
Days Days Days OIC- Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_3.000 _Days with pay
________Days without pay
________Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
FLORENTINO B. PINAROC
OIC - Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office DIVINO PERLAS RECAÑA
3. Date of Filing 4. POSITION 5. SALARY
February 28, 2018 Const. & Maint. Cap. P 9,991.50
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ SPL ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______10.000______Days ( ) Requested

INCLUSIVE DATES: __10-Day Monetization__ _________

___ DIVINO R. PERLAS __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ February 29, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
15.713 : 15.295 : 31.008
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__10.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

M. S. W. D. O. MALVAR JEROSA SOSA
3. Date of Filing 4. POSITION 5. SALARY
January29, 2017 Social Welfare Officer I P 29, 039.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

_______JEROSA S. MALVAR _____

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ December 31, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
88.095 : 155.745 : 243.840
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Secretariat Office Reassigned ZOLETA JOSEPHINE FERRER
3. Date of Filing 4. POSITION 5. SALARY
October 2, 2017 Const. and Maint. Man P 8,509.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( X ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______1.500______Days ( ) Requested

INCLUSIVE DATES: __September 27, 28am, 2017_________

___JOSEPHINE F. ZOLETA __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ August 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
87.742 : 154.320 : 242.062
================================ PHOEBE JOY D. BARRAMEDA
Days Days Days SB Secretary
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
______ Days with pay
________Days without pay
_______ Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB LEGISLATIVE OFFICE PE ARLEIGH VILLAROSA
3. Date of Filing 4. POSITION 5. SALARY
February 1, 2017 SB Member P 49,640.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Monetization____________ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______15.000______Days ( ) Requested

INCLUSIVE DATES: __15-Day Monetization___________

___ ARLEIGH V. PE __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ January 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
53.750 : 97.250 : 151.000
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
______ Days with pay
________Days without pay
15.000 Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized abse
5. nce.
6. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Secretariat Office BARRAMEDA PHOEBE JOY DUSABAN
3. Date of Filing 4. POSITION 5. SALARY
August 7, 2018 SB Secretary P 42,981.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
___________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______3.000______Days ( ) Requested

INCLUSIVE DATES: __July 17-19, 2017______

___PHOEBE JOY D. BARRAMEDA__

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ June 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
16.546 : 14.250 : 30.796
================================ Hon. ANTONIO E. GRATE,JR.
Days Days Days OIC - Municipal Vice Mayor
(Head of Office)

SHERYL T. SOTTO ____

Administrative Aide IV / HRM Aide
7. C APPROVED FOR :
3.000 Days with pay
________Days without pay
________Others (Please Specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
Hon. ANTONIO E. GRATE, JR.
OIC - Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Legislative Office GRATE, JR. ANTONIO ESTOY
3. Date of Filing 4. POSITION 5. SALARY
May 28, 2018 SB Member P 54,974.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
___________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______9.000______Days ( ) Requested

INCLUSIVE DATES: __May 15-18, 21-25,2018______

___ANTONIO E. GRATE, JR.__

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ April 30, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
27.500 : 27.500 : 55.000
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA ____

Acting HRMO
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
9.000 Days with pay ___________________________________________
________Days without pay ___________________________________________
________Others (Please Specify) ___________________________________________

______________________________________
(Signature)
HANNILEE REY SIENA
Municipal Vice Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Agriculture Office CASTRO, JR. FELIMON SELDA
3. Date of Filing 4. POSITION 5. SALARY
December 12, 2016 Agricultural Technologist P 13,684.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
___MONETIZATION_______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______15.000______Days ( ) Requested

INCLUSIVE DATES: __15-Day Monetization______

___FELIMON S. CASTRO, JR.__

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ November 30, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
65.358 : 156.450 : 221.808
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
Days with pay ___________________________________________
________Days without pay ___________________________________________
15.000_Others (Monetization) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Budget Office SOTTO EMMA FERNANDEZ
3. Date of Filing 4. POSITION 5. SALARY
January 3, 2019 Municipal Budget Officer P 66,740.00
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
___Privilege Leave___________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______3.500______Days ( ) Requested

INCLUSIVE DATES: __ December 3-4,27,28pm 2018 ______

___ EMMA F. SOTTO__

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ November 30, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
9.711 : 234.525 : 244.236
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

SORPRESA G. SADIWA
HRM Aide
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
_3.500 Days with pay ___________________________________________
________Days without pay ___________________________________________
_____ __Others (Others specify) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office SOTTO SHERYL TELAN
3. Date of Filing 4. POSITION 5. SALARY
May 6, 2019 Administrative Aide IV P 9,987.00
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 ( ) Abroad (Specify)
____________________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______8.000______Days ( ) Requested

INCLUSIVE DATES: __April 22,24-26,29-30, May 2-3 2019_ __

___ SHERYL T. SOTTO_ _

(Signature of Applicant)

DETAILS OF ACTION APPLICATION

7. A Certification of Leave Credits
7.B Recommendation
As of __March 31, 2019________ ( X ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
21.270 : 21.875 : 44.645
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
8.000 Days with pay ___________________________________________
______ Days without pay ___________________________________________
______Others (Please specify) ___________________________________________

RUSSEL SARMIENTO MADRIGAL

Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Assessor’s Office FABRERO LEA PERALTA
3. Date of Filing 4. POSITION 5. SALARY
June 14, 2017 Assessment Clerk I P 9,116.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
___Special Privilege Leave_ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______2.000______Day ( ) Requested

INCLUSIVE DATES: __June 15-16, 2017______

__LEA P. FABRERO_ _
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___June 13, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
26.162 : 92.250 : 133.412
================================ RAMON A. QUEJANO
Days Days Days Municipal Engineer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
______ Days with pay ___________________________________________
________Days without pay ___________________________________________
_2.000 _ Others (SPL) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office JANDA CHRISTOPHER SADIWA
3. Date of Filing 4. POSITION 5. SALARY
November 7, 2017 Admin Aide I P 7,693.50
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
___ _______ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______3.500______Days ( ) Requested

INCLUSIVE DATES: __October 24pm, 25-27, 2017________

__ CHRISTOPHER S. JANDA__
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ September 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
15.308 : 68.750 : 84.058
============================== ENGR. RAMON A. QUEJANO
Days Days Days Municipal Engineer
(Immediate Supervisor)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_3.500_ Days with pay
_________Days without pay
_________Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Mayor’s Office JANDA CHRISTOPHER SADIWA
3. Date of Filing 4. POSITION 5. SALARY
March 2, 2017 Admin Aide I P 7,693.50
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______12.000______Days ( ) Requested

INCLUSIVE DATES: __February 13-17,20-24, 27-28, 2017________

__CHRISTOPHER S. JANDA__
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Janaury 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
15.808 : 80.750 : 96.558
============================== RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_12.000_ Days with pay
_________Days without pay
__ _Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME ( LAST) (FIRST) (MIDDLE)

Municipal Health Office ROSAS ESTER MAPACPAD
3. Date of Filing 4. POSITION 5. SALARY
February 28, 2017 Midwife III P 21,307.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ ____________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ _____________________ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For ______27.234______Days ( ) Requested

INCLUSIVE DATES: __27.234 Terminal Leave __ _________

___ ESTER M. ROSAS __

(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ February 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
23.005 : 4.229 : 27.234
================================ ELEANOR MAY D. GRATE,MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
_27.234 Others (Terminal Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Treasurer’s Office SAGUID ANTONIO S.
3. Date of Filing 4. POSITION 5. SALARY
February 13, 2017 Municipal Treasurer P 46, 259.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Terminal Leave Benefit ____________
( x ) Sick
( ) Maternity
( X ) Others (Specify)
_____ Terminal Leave Benefit____________
6. C Number of Working Days/Applied
For ______76.031______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __Terminal Leave Benefit__ _________

_____ANTONIO S. SAGUID __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ October 15, 2016________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
66.110 : 9.921 : 76.031
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
_76.031_Others (Terminal Leave Benefit)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.

CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mun. Health Office SALVACION ELENA AREVALO
3. Date of Filing 4. POSITION 5. SALARY
March 13, 2017 Midwife II P 21,307.00
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X ) Others
_ Monetization ____________
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ _____________________
6. C Number of Working Days/Applied
For ______15.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __15-Day Monetization__ _________

_ ELENA A. SALVACION __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ Febuary 28, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
148.599 : 252.100 : 400.699
================================ ELEANOR MAY D. GRATE, MD.
Days Days Days Municipal Health Officer
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR :
_______Days with pay
________Days without pay
__15.00_Others (MONETIZATION)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.

CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Legislative Office SECO ROLAND VITTO
3. Date of Filing 4. POSITION 5. SALARY
November 6, 2017 SB Member P 49,640.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( X ) Abroad (Specify)
_ Forced Leave _______ __________Hongkong and Macao__________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____5.000______Days ( ) Requested

INCLUSIVE DATES: __November 20-24, 2017__ __

_ _ROLAND V. SECO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits 7.B Recommendation
As of ___ October 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
91.000 : 106.250 : 197.250
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR : 7. D DISAPPROVED DUE TO:
5.000 Days with pay ___________________________________________
________Days without pay ___________________________________________
_______ Others (Please specify) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.

CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

SB Legislative Office PE ARLEIGH VILLAROSA
3. Date of Filing 4. POSITION 5. SALARY
October 12, 2017 SB Member P 49,640.25
6. Type of Leave 6.B Where leave will be spent

( X ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( X ) Others ( ) Abroad (Specify)
_ Special Privilege Leave _______ ______________________________________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____1.000______Days ( ) Requested

INCLUSIVE DATES: __October 02, 2017__ _________

_ _ ARLEIGH V. PE __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ September 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
48.750 : 106.250 : 155.000
================================ HANNILEE REY SIENA
Days Days Days Municipal Vice Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR: 7. D DISAPPROVED DUE TO:
____ Days with pay ___________________________________________
_______Days without pay ___________________________________________
_1.000__Others (Please specify) ___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filled in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filled in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance
from no money and property accountability.

CSCFORM NO. 6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)
Mayor’s Office MERCADO ROLLY SALVACION
3. Date of Filing 4. POSITION 5. SALARY
October 12, 2017 Administrative Aide IV P 9,695.25
6. Type of Leave 6.B Where leave will be spent

( ) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( ) Abroad (Specify)
_ _______ ________________ ______________________________________
( X ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
_____ ___________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____1.000______Days ( ) Requested

INCLUSIVE DATES: __September 04, 2017__ _________

_ _ ROLLY S. MERCADO __
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ August 31, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
49.130 : 237.500 : 286.630
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
1.000 Days with pay
________Days without pay
_______ Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

11. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
12. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
13. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
14. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
15. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

MSWDO MASCARINAS ALMA RAMOS
3. Date of Filing 4. POSITION 5. SALARY
 January 5, 2018 Day Care Worker I P 11,393.00
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
(X) Others
_ SPECIAL PRIVELEGE LEAVE __
( ) Sick
( ) Maternity
( ) Others (Specify)
_____ ___________________ _____
6. C Number of Working Days/Applied
For _____3.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __DECEMBER 27-29, 2017__ _________

ALMA R. MASCARINAS _
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ NOVEMBER 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
31.244 : 174.140 : 205.384
================================ JESROSA S. MALVAR
Days Days Days Social Welfare Officer III
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
____ _Days with pay
________Days without pay
__3.000 _Others (Special Privilege Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

16. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
17. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
18. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
19. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
20. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.

CSCFORM NO. 6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)
Mayor’s Ofice ABE VIOLETA LATORRE
3. Date of Filing 4. POSITION 5. SALARY
January 5, 2018 CONSTRUCTION & MAINTENANCE MAN P 8,898.00
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

( ) To seek employment
( X) Others
SPECIAL PRIVILEGE LEAVE_________
(X) Sick
( ) Maternity
( ) Others (Specify)
____________________ _____
6. C Number of Working Days/Applied
For _____5.000______Days
( ) within the Philippines
( ) Abroad (Specify)
______________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __DECEMBER 21, 22 & 27-29, 2017__ _________

VIOLETA L. ABE_______
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ NOVEMBER 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
68.918 : 75.500 : 144.418
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
2.000 _Days with pay
________Days without pay
__3.000__Others (Special Privilege Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

21. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
22. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
23. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
24. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
25. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.

CSCFORM NO. 6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mayor’s Office GRAVE GIRLIE SALVACION
3. Date of Filing 4. POSITION 5. SALARY
January 8, 2018 CONSTRUCTION & MAINTENANCE MAN P 8,286.75
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

 ( ) To seek employment
( ) Others
FORCE LEAVE_________
( ) Sick
( ) Maternity
( ) Others (Specify)
____________________ _____
6. C Number of Working Days/Applied
For _____1.000______Days
( ) within the Philippines
( ) Abroad (Specify)
___________________________________
(2) In case of SICK LEAVE
( ) In hospital (Specify)
______________________________________
( ) Outpatient (Specify)
______________________________________
6. D Commutation
( ) Requested

INCLUSIVE DATES: __DECEMBER 29, 2017__ _________

GIRLIE S. GRAVE_______
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ NOVEMBER 30, 2017________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
13.505 : 25.582 : 39.087
================================ RUSSEL SARMIENTO MADRIGAL
Days Days Days Municipal Mayor
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
1.000 _Days with pay
________Days without pay
________Others (Special Privilege Leave)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Municipal Accounting Office OPEÑA ELIZABETH HERNANDEZ
3. Date of Filing 4. POSITION 5. SALARY
June 13, 2018 Administrative Assistant II P 12,212.00
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( X ) Abroad (Specify)
_______________________ ___________Hungary, Europe ____________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
____________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____33.000______Days ( ) Requested

INCLUSIVE DATES: __August 1-3,6-10,13-17,20-24,27-31, 2018

September 3-7,10-14, 2018 __ ______

ELIZABETH H. OPEÑA_______
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 31, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
2.809 : 2.333 : 5.142
================================ ONOFRE S. SOTTO
Days Days Days Municipal Accountant
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
_____ _Days with pay
_33.000__Days without pay
______ __Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of, an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

Statement of Leave Credits

Vacation Sick
Days Days

Balance as of March 31, 2019 22.520 22.125

Less: April 22, 2019 Sick Leave 0.000 1.000
Balance as of March 31, 2019 20.020 21.125

Certified Correct:

BERT S. FABRERO
Acting HRMO
CSCFORM NO. 6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (LAST) (FIRST) (MIDDLE)

Mayor’s Office REGIO ALMA LUNARIO
3. Date of Filing 4. POSITION 5. SALARY
May 16, 2019 Administrative Aide I P 12,212.00
6. Type of Leave 6.B Where leave will be spent

(X) Vacation (1) In case of VACATION LEAVE

( ) To seek employment ( ) within the Philippines
( ) Others ( X ) Abroad (Specify)
_______________________ ___________Hungary, Europe ____________
( ) Sick (2) In case of SICK LEAVE
( ) Maternity ( ) In hospital (Specify)
( ) Others (Specify) ______________________________________
____________________ _____ ( ) Outpatient (Specify)
______________________________________
6. C Number of Working Days/Applied 6. D Commutation
For _____33.000______Days ( ) Requested

INCLUSIVE DATES: __August 1-3,6-10,13-17,20-24,27-31, 2018

September 3-7,10-14, 2018 __ ______

ELIZABETH H. OPEÑA_______
(Signature of Applicant)
DETAILS OF ACTION APPLICATION
7. A Certification of Leave Credits
7.B Recommendation
As of ___ May 31, 2018________ ( ) Approval due to
____________________________________
================================ ( ) Disapproval due to
Vacation : Sick : Total ____________________________________
================================
2.809 : 2.333 : 5.142
================================ ONOFRE S. SOTTO
Days Days Days Municipal Accountant
(Head of Office)

PHOEBE JOY D. BARRAMEDA

Acting HRMO/SB Secretary
7. C APPROVED FOR:
_____ _Days with pay
_33.000__Days without pay
______ __Others (Please specify)
7. D DISAPPROVED DUE TO:
___________________________________________
___________________________________________
___________________________________________

______________________________________
(Signature)
RUSSEL SARMIENTO MADRIGAL
Municipal Mayor
(Authorized Official)

INSTRUCTIONS:

1. Application for vacation leave or sick leave for one full day or more shall be made on this form and to be
accompanied at least in duplicate.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going such
leave.
3. Application for sick leave shall be filed in advance or exceeding five days shall be accompanied by a medical
certificate in case medical consultation was not availed of, an affidavit should be executed to the applicant.
4. An employee who absent without approved leave shall not be entitled to receive his salary corresponding to
the period of his unauthorized absence.
5. An applicant for leave of absence for thirty (30) calendar days more shall be accompanied by a clearance from
no money and property accountability.
CSCFORM NO. 6
Revised 1984
APPLICATION FOR LEAVE

Statement of Leave Credits

Vacation Sick
Days Days

Balance as of March 31, 2019 21.270 21.875

Less: April 22,24-26,29-30, May 2-3, 2019 SL 21.270 8.000
Balance as of March 31, 2019 0 13.875

Certified Correct:

PHOEBE JOY D. BARRAMEDA

Acting HRMO