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CSC Form - Leave Application

The document is an application for leave form containing details about the type of leave being requested, the number of days, inclusive dates, and certification of available leave credits. It requests information such as the employee name and number, type of leave including vacation, sick, maternity or special privilege, where the leave will be spent, and whether commutation is requested. The form is then used to provide details of action on the application including certification of leave credits, recommendation for approval or disapproval, and space for an authorized official's approval or disapproval with reasons.

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Mark Ian Puno
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630 views1 page

CSC Form - Leave Application

The document is an application for leave form containing details about the type of leave being requested, the number of days, inclusive dates, and certification of available leave credits. It requests information such as the employee name and number, type of leave including vacation, sick, maternity or special privilege, where the leave will be spent, and whether commutation is requested. The form is then used to provide details of action on the application including certification of leave credits, recommendation for approval or disapproval, and space for an authorized official's approval or disapproval with reasons.

Uploaded by

Mark Ian Puno
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

CSC Form No.

_______
Revised 1984

APPLICATION FOR LEAVE


1. OFFICE/AGENCY 2. a) NAME 2. b) EMPLOYEE NO.
(Last) (First) (Middle)

3. DATE OF FILING 4. POSITION 5. SALARY(Monthly)

M M D D Y Y Y Y

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 Within the Philippines
Others, specify: _______________ Abroad (specify) ____________________
Sick
Maternity 2. IN CASE OF SICK LEAVE
Others, specify: __________________ __ In Hospital (Specify) _________________
Special Privilege Out Patient (Specify)___ ________
Birthday Relocation
Filial Hospitalization 6. d) COMMUTATION
Anniversary Mourning Requested
Enrollment Funeral Not Requested
Graduation Gov’t Transaction
6. c) NUMBER OF WORKING DAYS
APPLIED FOR ______
INCLUSIVE DATES:
_____________________
(Signature of Applicant)
DETAILS OF ACTION ON APPLICATION
7. a) CERTIFICATION OF LEAVE CREDITS 7. b) RECOMMENDATION
As of ______________________ Approved
Disapproved due to ____________________
VACATION SICK TOTAL ____________________________________

______________________________ _________________
Personnel Officer Authorized Official
7. c) APPROVED FOR: 7. d) DISAPPROVED DUE TO:

days with pay


days without pay
others (specify)

________________________
Authorized Official

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