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New Format Form 6

This document is a Civil Service Form application for leave from an employee of the Department of Education Division of Davao City. It contains details about the applicant such as name, position, and salary. It also specifies the type of leave being applied for such as vacation leave, sick leave, maternity leave, or study leave. For the leave request, it provides the inclusive dates and number of working days. Recommendations from the administrative officer and school principal are included, as well as the final approval or disapproval from the Schools Division Superintendent.

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rosette Ungab
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95 views2 pages

New Format Form 6

This document is a Civil Service Form application for leave from an employee of the Department of Education Division of Davao City. It contains details about the applicant such as name, position, and salary. It also specifies the type of leave being applied for such as vacation leave, sick leave, maternity leave, or study leave. For the leave request, it provides the inclusive dates and number of working days. Recommendations from the administrative officer and school principal are included, as well as the final approval or disapproval from the Schools Division Superintendent.

Uploaded by

rosette Ungab
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Civil Service Form No.

6
Revised 2020

Republic of the Philippines


Department of Education
DIVISION OF DAVAO CITY

APPLICATION FOR LEAVE


1. OFFICE/DEPARTMENT/SCHOOL 2. NAME : (Last) (First) (Middle)

3. DATE OF FILING ___________________ 4. POSITION _____________________________ 5. SALARY _____________________

6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:
Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines _______________________________
Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) ___________________________________
Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness) __________________________
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness) __________________________
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) __________________________________________________
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Special Leave Benefits for Women:
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) (Specify Illness) ________________________________________
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) ___________________________________________________
Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
Adoption Leave (R.A. No. 8552) BAR/Board Examination Review
Other purpose:
Others: Monetization of Leave Credits
Personal Leave ______________________________________ Terminal Leave

6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION


________________________________________ Not Requested
INCLUSIVE DATES Requested
______________________________________
(Signature of Applicant)

7. DETAILS OF ACTION ON APPLICATION


7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
As of _______________________ For approval
Vacation Leave Sick Leave For disapproval due to ________________________________
Total Earned
_____________________________________________________
Less this application
_____________________________________________________
Balance

_________________________________________________
ROMEL L. TAMBIS ROMULO N. PERALTA, EdD
Administrative Officer IV Principal II / School Head
7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:

days with pay ___________________________________________

days without pay ___________________________________________


others (Specify) ___________________________________________

REYNALDO M. GUILLENA, CESO V


Schools Division Superintendent

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