KAGAWARAN NG INTERYOR AT PAMAHALAANG LOKAL
(Department of the Interior and Local Government)
Regional Office IX
F.S. Fajares San jose District Pagadian City
CSC Form No. 6
APPLICATION
Revised 1984
1. OFFICE/AGENCY
FOR
LEAVE
2. NAME (Last)
DILG-RO IX
(First)
EGAMA
3. DATE OF FILING
(Middle)
ELMER
LACAYA
4. POSITION
AUGUST 10, 2012
5. SALARY (Monthly)
STAT.I
DETAILS OF APPLICATION
6. TYPE OF LEAVE
x
VACATION (FORCED LEAVE)
To seek employment
Others (Specify)
Sick Leave
Maternity
Terminal
Others (Specify) ______
7. WHERE LEAVE WILL BE SPENT:
(1) IN CASE OF VACATION LEAVE
Within the Philippines
Abroad (specify)
_________________________________________
(2) IN CASE OF SICK LEAVE
In-Hospital
Out-Patient (Specify) _______________
8. NUMBER OF WORKING DAY
APPLIED FOR
AUGUST 23 & 30, 2012
INCLUSIVE DATES
(3) COMMUTATION
Requested
Not Requested
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
9. CERTIFICATION OF LEAVE CREDITS
AS OF _______________________________
RECOMMENDATION
( ) APPROVED
VACATION
SICK
TOTAL
( ) DISAPPROVED DUE TO _______________________
_________________________________________________
__EVA N. SABANAL
FIORELLO G. ELIZAGA
Administrative Officer IV
10. APPROVED FOR:
DAYS WITH PAY
DAYS WITHOUT PAY
Chief, LGMED
( Authorized Official)
11. DISAPPROVED DUE TO:
_____________________________________
_____________________________________
PAISAL O, ABUTAZIL, CESO III
Regional Director
KAGAWARAN NG INTERYOR AT PAMAHALAANG LOKAL
(Department of the Interior and Local Government)
Regional Office IX
F.S. Fajares San jose District Pagadian City
CSC Form No. 6
APPLICATION
Revised 1984
1. OFFICE/AGENCY
FOR
LEAVE
2. NAME (Last)
DILG-RO IX
RULE
3. DATE OF FILING
(First)
(Middle)
RACHELLE
AGUILAR
4. POSITION
JANUARY 27, 2011
5. SALARY (Monthly)
LGOO II
DETAILS OF APPLICATION
6. TYPE OF LEAVE
/ VACATION
To seek employment
Others(Specify)
/
Maternity
Terminal
Others (Specify) _______________
7. WHERE LEAVE WILL BE SPENT:
(1) IN CASE OF VACATION LEAVE
Within the Philippines
Abroad (specify)
_________________________________________
(2) IN CASE OF SICK LEAVE
In-Hospital
Out-Patient (Specify) ________________
8. NUMBER OF WORKING DAY
APPLIED FOR
2 days
INCLUSIVE DATES
January 28 & 31, 2011
(3) COMMUTATION
Requested
Not Requested
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
9. CERTIFICATION OF LEAVE CREDITS
AS OF _______________________________
RECOMMENDATION
( ) APPROVED
VACATION
SICK
TOTAL
( ) DISAPPROVED DUE TO _______________________
_________________________________________________
LOURDES V. UTUTALUM
FIORELLO G. ELIZAGA
Human Resource Management Officer III
Chief, LGMED
(Authorized Official)
10. APPROVED FOR:
DAYS WITH PAY
DAYS WITHOUT PAY
11. DISAPPROVED DUE TO:
_____________________________________
_____________________________________
PAISAL O, ABUTAZIL, CESO III
Regional Director