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Application for Leave of Absence Application for Leave of Absence

Date: ______________ Date: ______________

Name: ________________________________________________ Name: ________________________________________________

Section/Division: ______________________________________ Section/Division: ______________________________________

Date of Leave: _________________ No. of day/s: ___________ Date of Leave: _________________ No. of day/s: ___________

____VL ____SL ____EL ____MT ___Others ____VL ____SL ____EL ____MT ___Others

Remarks: Remarks:
______________________________________________________ ______________________________________________________
______________________________________________________ ______________________________________________________
______________________________________________________ ______________________________________________________

Applicant’s Signature: ______________________ Applicant’s Signature: ______________________

Approved by: Approved by:


Immediate Superior: ________________________ Immediate Superior: ________________________

For HRD use only For HRD use only


VL SL EL MT OTHERS VL SL EL MT OTHERS
LEAVE CREDITS LEAVE CREDITS
LESS: THIS LEAVE LESS: THIS LEAVE
BALANCE BALANCE

Noted by: Noted by:

________________________ ________________________
STELLA V. ZAPANTA STELLA V. ZAPANTA
VP – HR and Administration VP – HR and Administration
Note: For Sick leave of more than 3 days, please attach medical certificate. Note: For Sick leave of more than 3 days, please attach medical certificate.

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