DEPARTMENT OF EDUCATION

MIMAROPA Region
SCHOOLS DIVISION OF BUKIDNON
Puerto Princesa City

APPLICATION FOR LEAVE

CSC Form 6
(Revised 2015)
1. Office/Agency Employee ID/Numbe 4371113
DepED - Division of Palawan School/Office: DEPED/ TRANQUILINO L. OBLAN ES
District: SAN VICENTE
Employee Contact Number: 9461783290

2. Name ADION ALDRIN NANGIT

(Last Name) (First Name) (Middle Name)

3. Date of Filing: 4. Position: TEACHER III

5. Monthly Salary: ₱ 25, 232.00

6. a. Type of Leave 6.b. Where leave will be spent in case of Vacation Leave?
Vacation Leave
To seek employment
Forced Leave
Sick Leave In case of Sick Leave, please specify the place of recovery.
Maternity Leave
Others (Please specify)

Commutation Requested
7. Number of working days applied: Not Requested
Inclusive date 9/22/2017
ALDRIN N. ADION
(Signature over Printed Name of Employee)

ARLANTE N. INVENTOR
(Signature over Printed Name of Immediate Head)

DETAILS OF ACTION ON APPLICATION

7. A. Certification of Leave Credits 7. B. Recommendation
Vacation Leave Sick Leave Total Leave Vacation Leave Sick Leave Total Leave
Credits Credits Credits Credits Credits Credits

ISABELITA A. SAMPAYAN
Administrative Officer V
7. C. APPROVED FOR: 7. D. DISAPPROVED due to:

days with pay

days without pay

NATIVIDAD P. BAYUBAY Ph. D.

OIC - Schools Division Superintendent
1. Application for vacation or sick leave for one full day or more shall be made on this form and to be accomplished in four copies.
2. Application for vacation leave shall be filed in advance. In case of sick leave five days and above shall be accompanied with medical certificate.
3. An employee who is absent without approved leave shall not be entitled to receive his salary corresponding the period his authorized leave of absence.