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APPLICATION FOR LEAVE CSC Form No. 6 Revised 1984 OFFICE / AGENCY DepEd Marikina DATE OF FILING NAME Last 4. POSITION DETAILS OF APPLICATION a TYPE OF LEAVE Vacation o To seek employment o Others specify Sick Maternity c NUMBER OF WORKING DAYS APPLIED For First Middle SALARY Monthly b WHERE LEAVE WILL BE SPENT 1. IN CASE OF VACATION LEAVE o Within the Philippines o Abroad specify o Out Patient specify d COMMUTATION o Requested Not Requested Signature of applicant INCLUSIVE DATES DETAILS OFACTION OF APPLICATION a CERTIFICATION OF LEAVE CREDITS As of Days e RECOMMENDATION o Approval o Disapproval due to Total WILMA P. MONTALLA Personnel Officer c APPROVED FOR d DISAPPROVED DUE TO CLARO L* CAPCO Administrative Officer V Authorized official. POSITION DETAILS OF APPLICATION a TYPE OF LEAVE Vacation o To seek employment o Others specify Sick Maternity c NUMBER OF WORKING DAYS APPLIED For First Middle SALARY Monthly b WHERE LEAVE WILL BE SPENT 1. IN CASE OF VACATION LEAVE o Within the Philippines o Abroad specify o Out Patient specify d COMMUTATION o Requested Not Requested Signature of applicant INCLUSIVE DATES DETAILS OFACTION OF APPLICATION a CERTIFICATION OF LEAVE CREDITS As of Days e RECOMMENDATION o Approval o Disapproval due to Total WILMA P. IN CASE OF VACATION LEAVE o Within the Philippines o Abroad specify o Out Patient specify d COMMUTATION o Requested Not Requested Signature of applicant INCLUSIVE DATES DETAILS OFACTION OF APPLICATION a CERTIFICATION OF LEAVE CREDITS As of Days e RECOMMENDATION o Approval o Disapproval due to Total WILMA P. MONTALLA Personnel Officer c APPROVED FOR d DISAPPROVED DUE TO CLARO L* CAPCO Administrative Officer V Authorized official. POSITION DETAILS OF APPLICATION a TYPE OF LEAVE Vacation o To seek employment o Others specify Sick Maternity c NUMBER OF WORKING DAYS APPLIED For First Middle SALARY Monthly b WHERE LEAVE WILL BE SPENT 1. IN CASE OF VACATION LEAVE o Within the Philippines o Abroad specify o Out Patient specify d COMMUTATION o Requested Not Requested Signature of applicant INCLUSIVE DATES DETAILS OFACTION OF APPLICATION a CERTIFICATION OF LEAVE CREDITS As of Days e RECOMMENDATION o Approval o Disapproval due to Total WILMA P. MONTALLA Personnel Officer c APPROVED FOR d DISAPPROVED DUE TO CLARO L* CAPCO Administrative Officer V Authorized official.

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