APPLICATION FOR LEAVE

CSC Form No. 6 (Revised 1994)

Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________ _______________________
Squad Leader Admin Officer
___________________________________________
Squad Leader Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

______________________
Chief of Police
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________ _______________________
Squad Leader Chief of Police
___________________________________________
Squad Leader Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

______________________
C, PPHRDB/C, CPHRDB
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


_______________________
C, PPHRDB/C, CPHRDB
___________________________________________
Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
Provincial Director/City Director
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________ _______________________
Squad Leader Chief of Branch
___________________________________________
Squad Leader Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
C, PPHRDB/C, CPHRDB
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________ _______________________
Chief of Branch C, PPHRDB/C, CPHRDB
___________________________________________
Squad Leader Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
Provincial Director/City Director
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________ _______________________
C, PPHRDB/C, CPHRDB Squad DPDA/DCDA
___________________________________________
Leader Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
Provincial Director/City Director
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


______________________
C, RPRMD
______________________ _______________________
CRS DRDA
___________________________________________
Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
Regional Director
______________________
Squad Leader
(Signature)
__________________
(Authorized Official)
 APPLICATION FOR LEAVE
CSC Form No. 6 (Revised 1994)
Date Entered Service : Badge No. :
1. OFFICE/AGENCY: 2. NAME (Last) (First) (Middle)

3. DATE OF FILING: 4. RANK/POSITION: (Status of Appointment) 5. SALARY:

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

 VACATION IN CASE OF VACATION LEAVE:
 SICK  Within the Philippines
 MANDATORY  Abroad (Specify)
 PATERNITY
 MATERNITY
 PRIVILEGE IN CASE OF SICK LEAVE:
To seek employment In hospital (Specify)



Others(Specify) : Out Patient (Specify)

 

6. NUMBER OF WORKING DAYS (c) COMMUTATION:

APPLIED FOR:  Requested
 Not Requested
47INCLUSIVE DATES: _________________________
(Signature of Applicant)
ADDRESS:

DETAILS OF ACTION ON APPLICATION

7. (a) CERTIFICATION OF LEAVE CREDITS (b) RECOMMENDATION
As of_____________________  Approval
Vacation Sick Total Disapproved due to:


_______________________
C, PPHRDB/C, CPHRDB
___________________________________________
Squad Leader
Personnel Officer (Authorized Official)
8. (a) APPROVED FOR: 8. (b) DISAPPROVED DUE TO:
Days with pay
Days without pay
Others (Specify)

_____________________________
Provincial Director/City Director
______________________
(Signature)
__________________
(Authorized Official)