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Application for Leave - Regional Field Office
HLURB regional field office application for leave
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: APPLICATION FOR LEAVE
CSC Form No. 6
Revised 1984
1. OFFICE/AGENCY
2. NAME
(Last)
(First)
(Middle)
HOUSING AND LAND USE REGULATORY BOARD
3. DATE OF FILING
4. POSITION
5. SALARY (Monthly)
DETAILS OF APPLICATION
6. a) TYPE OF LEAVE
6. b) WHERE LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE
Vacation
To seek employment
Others (Specify) _____________
___________________________
x
Within the Philippines
Abroad (Specify) __________________
_________________________________
2. IN CASE OF SICK LEAVE
Sick
In Hospital (Specify) ________________
_________________________________
Maternity
Others (Specify) _____________________
___________________________________
6. c) NUMBER OF WORKING DAYS APPLIED
FOR _______________________________
Out Patient (Specify) ________________
_________________________________
6. d) COMMUTATION
Requested
INCLUSIVE DATES
Not requested
_______________________
________________________
(Signature of Applicant)
DETAILS OF ACTION OF APPLICATION
7. a) CERTIFICATION OF LEAVE CREDITS
as of _______________________________
7. b) RECOMMENDATION
Approval
Vacation
Sick
Total
Days
Days
Days
Disapproval due to ___________________
___________________________________
RUNEL B. TANINGCO
____________________
Supervisor
LINDA L. MALENAB-HORNILLA
____________________________
________________________________
Commissioner-in-Charge
(Personnel Officer)
7. c) APPROVED FOR:
________________ days with pay
________________ days without pay
________________ others (Specify)
7. d) DISAPPROVED DUE TO:
_______________________________________
_______________________________________
_________________________
(Signature)
_________________________________
(Authorized Official)
DATE: _____________
HLURB Ver. 01
