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Elective Local Officials Personal Data Sheet
DILG personal data sheet for elective local officials
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT
DILG-NAPOLCOM Center, EDSA cor. Quezon Avenue, Quezon City
www.dilg.gov.ph
APPLICATION FOR LEAVE
Name
CSC Form No. (Revised 1985)
TYPE OF LEAVE
Signature
VACATION
Mo. Salary
Within the Philippines
Abroad (Specify)
Position
Office/Division
SICK
Date of Filing
Out Patient (specify)
In In Hospital (specify)
No. of working days applied for
Inclusive Dates
FORCED LEAVE
CSC-SPL
COMMUTATION:
MATERNITY
REHABILITATION
TERMINAL
Others (specify)
Requested
Not Requested
FOR PERSONNEL USE ONLY:
VL
ACTION ON APPLICATION
Recommending:
SL
Leave credits as of
TOTAL
Approval
Disapproval due to
Less: This Leave
Balance:
[Autohorized Official]
CERTIFIED BY:
APPROVED FOR
Chief, Personnel Section/Division
Days w/ Pay
Days w/o Pay
DISAPPROVED DUE TO
Carded by:
Date:
[Authorized Official]
