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Appli. For Leave CSC Form No. 6 by billycorgann

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									CSC FORM NO. 6
Revised 1985


                                         APPLICATION FOR LEAVE

1. OFFICE/AGENCY                       2. NAME (Last)               (First)                           (Middle)


3. DATE OF FILING                      4. POSITION                            5. Salary (Monthly)


                                            6. DETAILS OF APPLICATION
6. A) TYPE OF LEAVE                                         6. B) WHERE LEAVE WILL BE SPENT :
                                                                  1) IN CASE OF VACATION LEAVE
               Vacation                                                  Within the Philippines
                  To seek employment                                     Abroad (Specify)
                  Others (Specify)

                                                                    2) IN CASE OF SICK LEAVE
                  Sick                                                     In Hospital (Specify)
                  Maternity
                  Others (Specify)                                            Out Patient (Specify)


6. C) NUMBER OF WORKING DAYS APPLIED FOR                    6. D) COMMUTATION
                                                                    Requested                  Not Requested

       INCLUSIVE DATES
                                                                                          (Signature of Applicant)


                                     7. DETAILS OF ACTION ON APPLICATION
7. A) CERTIFICATION OF LEAVE CREDITS                        7. B) RECOMMENDATION
      as of
                                                                          Approval
       Vacation              Sick             Total

                                                                          Disapproval due to
           days              days             days


                               (Personnel Officer)                                          (Authorized Official)

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

                               days with pay
                               days without pay
                               other (Specify)




                                                      (Signature)
DATE :


                                                  (Authorized Official)

								
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