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Leave Form
FMB application form for leave
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: APPLICATION FOR LEAVE
1.
OFFICE/AGENCY
2.
NAME (Last, First, Middle)
4.
POSITION
Forest Management Bureau
3.
DATE OF FILING
6.
5.
DETAILS OF APPLICATION
6.A. TYPE OF LEAVE
SALARY (Monthly)
6.B. WHERE LEAVE WILL BE SPENT
1. IN CASE OF VACATION LEAVE
Vacation
Within the Philippines
To seek employment
Abroad
Others
(Specify)
(Specify)
2.
IN CASE OF SICK LEAVE
Sick
In Hospital
Maternity
(Specify)
Others
Out-Patient
(Specify)
(Specify)
6.C. NUMBER OF WORKING DAYS APPLIED
6.D. COMMUTATION
FOR:
Requested
Not requested
INCLUSIVE DATES
Signature of Applicant
7.
DETAILS OF ACTION ON THE APPLICATION
7.A CERTIFICATION OF LEAVE CREDITS
As of
7.B. RECOMMENDATION
Approval
Vacation
days
Sick
days
Total
days
Personnel Officer
Disapproval due to
Immediate Supervisor
7.C. APPROVED FOR
7.D. DISAPPROVED DUE TO:
day(s) with pay
day(s) without pay
others (Specify)
(SIGNATURE)
(AUTHORIZED OFFICIAL)
Date:
2017/fppkmd-kiss/eve
