APPLICATION FOR LEAVE

1. OFFICE/AGENCY 2. NAME (last) (first) (middle)

Office of the Provincial Prosecutor ORAA MARK JOSEPH A.
Quezon
3. DATE OF FILING 4. POSITION 5. SALARY (monthly)
June 5, 2018 ADMINISTRATIVE AIDE IV

DETAILS OF APPLICATION

6. a) TYPE OF LEAVE 6. b) WHERE LEAVE WILL BE SPENT

X 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
_____SPL_________________ Out Patient (Specify)
__________________________

6. c) NUMBER OF WORKING DAYS APPLIED 6. d) COMMUTATION

FOR ONE (1)
INCLUSIVE DATES: Requested
June 11, 2018
_____________________________________ Not Requested
_____________________________________
MARK JOSEPH A. ORAA
(Signature of Applicant)

DETAILS OF ACTION ON APPLICATION

7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION

as of ______________________________
Approval
===============================
Vacation : Sick: Leave: Disapproved due to ____________

___________________________________
days days days

___________________________________ ERNESTO C. MENDOZA

(Personnel Officer) Regional Prosecutor

7. c) APPROVED FOR: 7. d) DISAPPROVED DUE TO:

______________________ days with pay __________________________________
______________________ days without pay __________________________________
______________________ others (specify)
date: _________

_________________________________________
(SIGNATURE OF AUTHORIZED OFFICIAL)