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form 6 & form 137 request

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APPLICATION FOR LEAVE CSC FORM 6 REVISED 1984 Employee No. 4165292 1. Office Agency 2. NAME (LAST) (FIRST) (MI) DEPED, Sta. Rita E/S BUENAOBRA MICHAEL ANGELO E. Olongapo City 3. Date of Filing 4. Position 5. Salary (Monthly) September 29, 2010 Teacher 1 P15,900.00 DETAILS OF APPLICATION 6. a) Type of Leave 6. b) Where LEAVE will be spent ( ) Vacation (1) IN CASE OF VACATION LEAVE ( ) To seek employment ( ) Within the Philippines ( ) Others (specify) ( ) Abroad (specify) ( ) Sick - Headache (2) IN CASE OF SICK LEAVE (/) Maternity ( ) In Hospital (specify) ( ) Others (specify) ( ) Out-patient (specify) (/) Requested (/) Not Requested c) Number of Working Days Applied For: 2 days INCLUSIVE DATES: September 29, 2010– September 29, 2010 Signature of Applicant DETAILS OF ACTION ON APPLICATION 7. a) CERTIFICATION OF LEAVE CREDITS b) RECOMMENDATION: As of ( ) Approved ( ) Disapproved due to Vacation : Sick : Total

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FORM 6 & fORM 137 REQUEST

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APPLICATION FOR LEAVE

APPLICATION FOR LEAVE

CSC FORM 6

REVISED 1984

Employee No. 4165292

1. Office Agency

2. NAME (LAST)

(FIRST)

(MI)

DEPED, Sta. Rita E/S BUENAOBRA MICHAEL ANGELO E. Olongapo City

3. Date of Filing

4. Position

5. Salary (Monthly)

September 29, 2010 Teacher 1

P15,900.00

DETAILS OF APPLICATION

6. a) Type of Leave

6. b) Where LEAVE will be spent

( ) Vacation

(1) IN CASE OF VACATION LEAVE

( ) To seek employment

( ) Within the Philippines

( ) Others (specify)

( ) Abroad (specify)

( ) Sick - Headache

(2) IN CASE OF SICK LEAVE

(/) Maternity

( ) In Hospital (specify)

( ) Others (specify)

( ) Out-patient (specify)

(/) Requested (/) Not Requested

c) Number of Working Days Applied For:

2 days

INCLUSIVE DATES:

September 29, 2010 September 29, 2010

Signature of Applicant

DETAILS OF ACTION ON APPLICATION

7. a) CERTIFICATION OF LEAVE CREDITS

b) RECOMMENDATION:

As of

( ) Approved

( ) Disapproved due to

Vacation :Sick :Total

: :

HERMINIGILDA M. ESCOBAR_

Principal IV

NOEL E. PATIAG

CLEOPATRA C. FLORES

(Personnel Officer)

District Supervisor

c) APPROVED FOR:

d) DISAPPROVED DUE TO:

days with pay

days without pay

NAOMI T. ARZADON

Asst. Schools Division Superintendent

DR. LIGAYA B. MONATO, CESO VSchools Division SuperintendentDepartment of Education

Region III

Division of City Schools

Olongapo District II

STA. RITA ELEMENTARY SCHOOL

Olongapo City

Date

The Principal

Dear Sir / Madam:

Kindly furnish us with certified copy / copies of the DepEd Form 137 E of the following pupil/pupils who are temporarily enrolled in our school.Name of PupilsNow in GradeIn Your SchoolFormer Teacher

GradeSchool Year

1st

2nd

3rd

Urgent

Very truly yours,

ROSARIO L. ALBINES

Principal IVDepartment of Education

Region III

Division of City Schools

Olongapo District II

STA. RITA ELEMENTARY SCHOOL

Olongapo City

Date

The Principal

Dear Sir / Madam:

Kindly furnish us with certified copy / copies of the DepEd Form 137 E of the following pupil/pupils who are temporarily enrolled in our school.Name of PupilsNow in GradeIn Your SchoolFormer Teacher

GradeSchool Year

1st

2nd

3rd

Urgent

Very truly yours,

ROSARIO L. ALBINES

Principal IV


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