Application for leave

1. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
SORIANO ANGELITA BALDONO
3. DATE OF FILING 4. POSITION
MASTER TEACHER II
5. SALARY (Monthly)
P 16, 496.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171598
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
ELIZABETH P. TULIOC
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________

2. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
TULIOC REMEDIOS TAMONDONG
3. DATE OF FILING 4. POSITION
TEACHER II
5. SALARY (Monthly)
P 12,522.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171515
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________

3. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
TULIOC REMEDIOS TAMONDONG
3. DATE OF FILING 4. POSITION
TEACHER II
5. SALARY (Monthly)
P 12,522.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171515
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________