application for leave - lgu makilalamakilala.gov.ph/downloads/forms/form6.pdf · application for...
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APPLICATION FOR LEAVE CSC Form No. 6 Revised 1984 ______ 1. OFFICE/AGENCY 2. NAME (Last) (First) (M.I.) MAYORS OFFICE /LGU-MAKILALA CAOAGDAN RUDY S. _______________________________________________________________________ 3. DATE OF FILING 4. POSITION 5. SALARY June 30, 2011 Municipal Mayor P 40,954.00 ____________________________________________________________________________ 6. a) TYPE OF LEAVE 6. b) WHERE LEAVE SPENT [ x ] Vacation [ ] In case of vacation leave [ ] To seek employment [ ] Within the Philippines [ ] Others (Specify) [ x ] Abroad (Specify) [ ] Sick [ ] In case of Sick Leave [ ] Maternity [ ] In Hospital (Specify) [ ] Others (Specify) 6. c) NUMBER OF WORKING DAYS 6. d) COMMUTATION APPLIED FOR: 2 days [ ] REQUESTED INCLUSIVE DATE: July 7,8,9(sat), 10(sun), 2011 [ ] NOT REQUESTED
RUDY S. CAOAGDAN, MPA (Municipal Mayor)
DETAILS OF ACTION ON APPLICATION 7. a) CERTIFICATION OF LEAVE 7. b) RECOMMENDATION CREDITS AS OF June 30, 2011 [ ] APPROVAL [ ] DISAPPROVAL VACATION: SICK : TOTAL 15.000 : 15.000 : 30.000 ( 2.000) : - :(2.000) ______________________________________ 13.000 15.000 28.000 ===================================== JIMMY H. CASIMERO, MPA RUDY S. CAOAGDAN, MPA (Municipal HRMO) (Municipal Mayor) 7.c) APPROVED FOR: 7. d) DISAPPROVED DUE TO:
Days with Pay Days without Pay Others (Specify)
EMMYLOU J. TALIÑO-MENDOZA (Signature)
Provincial Governor (Authorized Official)
Date:
1. Application for vacation leave or sick leave for one full day or more shall be made on this form to be accomplished at least in three (3) copies.
2. Application for vacation leave shall be filed in advance or whenever possible five (5) days before going for such leave.
3. Application for sick leave filed in advance or exceeding five (5) days shall be accompanied by a medical certificate in case medical consultation was not availed an affidavit should be executed by the applicant.
4. An employee who is absent without approved leave shall not be entitled to receive his/her salary corresponding to the period of his/her unauthorized leave of absence.