APPLICATION FOR LEA

CSC Form No. 6

Revised 1995
1. SCHOOL, EMP. NO., STA.
DepEd-Urdaneta City Division, 4204239, 255-095

3. DATE OF FILING

2. NAME (LAST)
ADVIENTO
4. POSITION

February 1, 2016

Administrative Assistant I

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

Sick
Maternity
Others (Specify):
Paternity Leave

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
7 days
Jan. 18-22, Jan. 27 (pm), Jan. 29, Feb. 11 (pm)

Inclusive Date/s

DETAILS OF ACTION ON APPLIC

7. a. CERTIFICATION OF LEAVE CREDITS:
As of

Vacation

Sick

Total

Day/s

Day/s

Day/s

LEONARDO C. SOREL
Administrative Officer V
7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:

GLORIA R. TORRES, CESO

Schools Division Superintende

CATION FOR LEAVE

AME (LAST)
ADVIENTO

OSITION

(FIRST)

(MIDDLE)

TRISTAN JUVENIO

URAP

5. SALARY PER MONTH

dministrative Assistant I

13,890.00

6. 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):

COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

OF ACTION ON APPLICATION
7. b. RECOMMENDATION:
Approved
Disapproved

IA R. TORRES, CESO V
s Division Superintendent

Mahalia Loren T. Gutierrez

Budget Officer III
(Authorized Official)
7. d. DISAPPROVED DUE TO:

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
ADVIENTO

DepEd-Urdaneta City Division, 4204239, 255-095

3. DATE OF FILING

4. POSITION
April 12, 2016

Administrative Assistant I

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Friday, April 08, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

LEONARDO C. SOREL
Administrative Officer V
7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:
GLORIA R. TORRES, CESO V
Schools Division Superintendent

EAVE

(FIRST)

(MIDDLE)

TRISTAN JUVENIO

URAP

5. SALARY PER MONTH

13,890.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

SO V
ndent

Mahalia Loren T. Gutierrez

Budget Officer III
(Authorized Official)

7. d. DISAPPROVED DUE TO:

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
ADVIENTO

DepEd-Urdaneta City Division, 4204239, 255-095

3. DATE OF FILING

4. POSITION
April 26, 2016

Administrative Assistant I

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Monday, April 25, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

LEONARDO C. SOREL
Administrative Officer V
7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:
GLORIA R. TORRES, CESO V
Schools Division Superintendent

EAVE

(FIRST)

(MIDDLE)

TRISTAN JUVENIO

URAP

5. SALARY PER MONTH

13,890.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

SO V
ndent

Mahalia Loren T. Gutierrez

Budget Officer III
(Authorized Official)

7. d. DISAPPROVED DUE TO:

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
GUTIERREZ

DepEd-Urdaneta City Division, 419559, 255-095

3. DATE OF FILING

4. POSITION
April 12, 2016

Administrative Officer V

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Monday, April 11, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

LEONARDO C. SOREL
Administrative Officer V
7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:
GLORIA R. TORRES, CESO V
Schools Division Superintendent

EAVE

(FIRST)

(MIDDLE)

MAHALIA LOREN

TIDOR

5. SALARY PER MONTH

33,452.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

SO V
ndent

Victor C. Nastor
OIC-Accountant III
(Authorized Official)

7. d. DISAPPROVED DUE TO:

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
GUTIERREZ

DepEd-Urdaneta City Division, 419559, 255-095

3. DATE OF FILING

4. POSITION
May 2, 2016

Administrative Officer V

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Friday, April 29, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:

ROSARIO O. CABRERA
Officer-In-Charge
Office of the Assistant Schools Division Super

EAVE

(FIRST)

(MIDDLE)

MAHALIA LOREN

TIDOR

5. SALARY PER MONTH

33,452.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

LEONARDO C. SOREL
Administrative Officer V

7. d. DISAPPROVED DUE TO:

RA
Superintendent

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
GUTIERREZ

DepEd-Urdaneta City Division, 419559, 255-095

3. DATE OF FILING

4. POSITION
May 11, 2016

Administrative Officer V

6. a. TYPE OF LEAVE
Vacation
To seek employment
Others (specify) :

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Tuesday, May 10, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:

ROSARIO O. CABRERA
Officer-In-Charge
Office of the Assistant Schools Division Super

EAVE

(FIRST)

(MIDDLE)

MAHALIA LOREN

TIDOR

5. SALARY PER MONTH

33,452.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

LEONARDO C. SOREL
Administrative Officer V

7. d. DISAPPROVED DUE TO:

RA
Superintendent

APPLICATION FOR LEAVE

CSC Form No. 6
Revised 1995
1. SCHOOL, EMP. NO., STA.

2. NAME (LAST)
GUTIERREZ

DepEd-Urdaneta City Division, 419559, 255-095

3. DATE OF FILING

4. POSITION
May 11, 2016

Administrative Officer V

6. a. TYPE OF LEAVE
Vacation
To seek employment
a
Others (specify) :
Special Leave (Filial Obligation)

6. b. WHERE LEAVE

Sick
Maternity
Others (Specify):

6. c. NUMBER OF WORKING DAYS

APPLIED FOR:
1 day
Wednesday, May 18, 2016
Inclusive Date/s

DETAILS OF ACTION ON APPLICATIO

7. a. CERTIFICATION OF LEAVE CREDITS:
As of
Vacation

Sick

Total

Day/s

Day/s

Day/s

7. c. APPROVED FOR:
day/s with pay
day/s without pay
others (specify)

APPROVED:

ROSARIO O. CABRERA
Officer-In-Charge
Office of the Assistant Schools Division Super

EAVE

(FIRST)

(MIDDLE)

MAHALIA LOREN

TIDOR

5. SALARY PER MONTH

33,452.00
LEAVE WILL BE SPENT:
1. IN CASE OF VACATION LEAVE:
Within the Philippines
Abroad (specify):

2. IN CASE OF SICK LEAVE:

In Hospital (specify):
COMMUTATION
Requested
Not Requested
______________
______________

Signature of Applicant

ICATION
7. b. RECOMMENDATION:
Approved
Disapproved

LEONARDO C. SOREL
Administrative Officer V

7. d. DISAPPROVED DUE TO:

RA
Superintendent