CSC FORM NO.

6
Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY

2. NAME

CMO-ICTD
3. DATE OF FILING

(Last)

NARIDO

(First)

(Middle Name)

MARK JUNNIES

GAHOB
5. SALARY (Monthly)

4. POSITION

07/07/2015

DATA CONTROLLER II

14, 939.00

6. DETAILS OF APPLICATION
6.a) TYPE OF LEAVE
Vacation
To seek employment
Others (Specity)
Sick
Maternity
Others (Specity)
6.c) NUMBER OF WORKING DAYS APPLIED ( )
INCLUSIVE DATES:

6.

1 Day

1 Day

6.

July 07, 2015

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)
Out Patient (Specify)
d) COMMUTATION
Not Requested
Requested

(Signature of Applicant)
7. DETAILS OF ACTION ON APPLICATION
7.a) CERTIFICATION OF LEAVE CREDITS
As of

VACATION

SICK

7.b) RECOMMENDATION
Approval
Disapproval due to

TOTAL

LEAH Y. TOLIMAO
CGDH II

(Authorized Official)
7.d) DISAPPROVED DUE TO:

7.c) APPROVED FOR:

Days with pay
Days without pay

Others (Specify)

By the Authority of the City Mayor:

RONNEL C. RIVERA
City Mayor

Date :

Gabriel Francis Glenville N. Gonzalez

Asst. City Administrator-Administration

CSC FORM NO. 6

Revised 1984

APPLICATION FOR LEAVE

1. OFFICE/AGENCY

2. NAME

CMO-ICTD
3. DATE OF FILING

(Last)

NARIDO

(First)

(Middle Name)

MARK JUNNIES

GAHOB
5. SALARY (Monthly)

4. POSITION

07/07/2015

DATA CONTROLLER II

14, 939.00

6. DETAILS OF APPLICATION
6.a) TYPE OF LEAVE
Vacation
To seek employment
Others (Specity)
Sick
Maternity
Others (Specity)
6.c) NUMBER OF WORKING DAYS APPLIED ( )
INCLUSIVE DATES:

6.

1 Day

1 Day

6.

July 07, 2015

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)
Out Patient (Specify)
d) COMMUTATION
Not Requested
Requested

(Signature of Applicant)
7. DETAILS OF ACTION ON APPLICATION
7.a) CERTIFICATION OF LEAVE CREDITS
As of

VACATION

SICK

7.b) RECOMMENDATION
Approval
Disapproval due to

TOTAL

LEAH Y. TOLIMAO
CGDH II

(Authorized Official)
7.d) DISAPPROVED DUE TO:

7.c) APPROVED FOR:

Days with pay
Days without pay

Others (Specify)

By the Authority of the City Mayor:

RONNEL C. RIVERA
Date :

City Mayor

Gabriel Francis Glenville N. Gonzalez

Asst. City Administrator-Administration