CSC Form 6

Revised 1998

APPLICATION FOR LEAVE

1. Office/Agency 2. Name (Last) (First) (Middle)
Cultihan-Bolbok
ES/Department of Education DE RAMOS ROWENA VITO
3. Date of Filing 4. Position 5. Salary
June 5, 2019 Teacher III Php 25,232
DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave

Maternity In hospital (Specify)
Others (Specify)
Special Leave of absence Under Magna
Carta for Women with Pay

6. C) Number of Working Days applied for: 6. D) Commutation

60 DAYS Requested Not Requested
Inclusive Dates
June 5, 2019 to August 3, 2019 ROWENA V. DE RAMOS
Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A) Certification of Leave Credits 7. B) Recommendation:
as of

Vacation Sick Total Approval

Disapproval due to
days days days

ERNANI A. CATAPAT RUTHMABELLE E. REYES

Authorized Official Authorized Official
7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

MANUELA S. TOLENTINO, CESO V

 Authorized Official

Date: _________________
CSC Form 6
Revised 1998

APPLICATION FOR LEAVE

1. Office/Agency 2. Name (Last) (First) (Middle)
Balisong ES/Department of
Education ATIENZA LIZBETH ROSALES
3. Date of Filing 4. Position 5. Salary
Teacher I Php 20,754.00
DETAILS OF APPLICATION
6. A) Type of Leave 6. B) Where Leave will be spent:
Vacation 1. In case of Vacation Leave
To seek employment Within the Philippines
Others (Specify) Abroad (Specify)

Sick 2. In case of Sick Leave

Maternity In hospital (Specify)
Others (Specify)

6. C) Number of Working Days applied for: 6. D) Commutation

Requested Not Requested
Inclusive Dates
LIZBETH R. ATIENZA
Signature of Applicant
DETAILS OF ACTION ON APPLICATION
7. A) Certification of Leave Credits 7. B) Recommendation:
as of

Vacation Sick Total Approval

Disapproval due to
days days days

ERNANI A. CATAPAT BELEN M. VILLANUEVA

Authorized Official Authorized Official
7. C) Approved for: 7. D) Disapproved due to:
days with pay
days without pay

Signature

MERTHEL M. EVARDOME, CESO V

Authorized Official

Date: _________________