Angelita Baldono, a Master Teacher II in the Department of Education Region I Pangasinan Division II, has applied for leave. Her application details her position, salary, the type of leave requested (not specified), the inclusive dates, and a request for cummulation of leave credits. The application form is then signed by Baldono and includes her employee number. The form is then completed by the appropriate administrators who will certify her leave credits, make a recommendation, and provide final approval or disapproval with the signature of the Schools Division Superintendent.

1. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
SORIANO ANGELITA BALDONO
3. DATE OF FILING 4. POSITION
MASTER TEACHER II
5. SALARY (Monthly)
P 16, 496.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171598
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
ELIZABETH P. TULIOC
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________

2. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
TULIOC REMEDIOS TAMONDONG
3. DATE OF FILING 4. POSITION
TEACHER II
5. SALARY (Monthly)
P 12,522.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171515
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________

3. APPLICATION FOR LEAVE
CSC Form 6
Revised 1984
1. OFFICE/AGENCY
Dept. of Education, Region I, Pangasinan Div. II
2. NAME (Last) (First) (Middle)
TULIOC REMEDIOS TAMONDONG
3. DATE OF FILING 4. POSITION
TEACHER II
5. SALARY (Monthly)
P 12,522.00
DETAILS OF APPLICATION
6. A. TYPE OF LEAVE
/ / Vacation
/ / To seek employment
/ / Others (specify) _____________
_____________
/ / Sick
/ / Maternity
/ / Others (specify) _____________
_____________
6. C. NUMBER OF WORKING DAYS APPLIED FOR:
_______________________________________
INCLUSIVE DATES _____________________
_______________________________________
B. WHERE LEAVE WILL BE SPENT
(1) IN CASE OF VACATION LEAVE
/ / Within the Philippines
/ / Abroad (specify) _____________
__________________________
(2) IN CASE OF SICK LEAVE
/ / In Hospital (specify) _____________
__________________________
CUMMATATION
/ / Requested / / Not requested
_______________________________
Signature of Applicant
Employee No. 171515
DEAILS OF ACTION OF APPLICATION
7. A. CERTIFCATION OF LEAVE CREDITS
1. Heads and Facilitative
Staff
Vacation
leave
Sick leave
Accumulative
Leave
Less: Absence
Requested
BALANCE
2. Teacher
Accumulative
Leave
Less: Absence
Requested
BALANCE
ARVIN R. PURISIMA
Administrative Officer V
7. B. RECOMMENDATION
/ / Approved
/ / Disapproved due to _____________
__________________________
Office of the School Principal
School: Manaoag National High School
District: Manaoag District
ELIZABETH P. TULIOC
District Supervisor
8. A. APPROVED FOR
___________ Days with pay
___________ Days without pay
___________ Others specify
8. A. DISAPPROVED DUE TO
_________________________________
_________________________________
VIRALUZ S. RAGUINDIN, CESO V
Schools Division Superintendent
Date: _________________________________