CS-Form-No.-6-Revised-2020-Application-for-Leave-Fillable-edited-for-MSU-Mag.xlsx

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1	Civil Service Form No. 6 Revised 2020
2	Republic of the Philippines MINDANAO STATE UNIVERSITY – MAGUINDANAO Datu Odin Sinsuat Municipality, Maguindanao Province, Philippines 9601
3	APPLICATION FOR LEAVE
4	1. OFFICE/DEPARTMENT				2. NAME : (Last) (First) (Middle)
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6	3. DATE OF FILING ______________				4. POSITION _____________________________ 5. SALARY _______________
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8		6. DETAILS OF APPLICATION
9	6.A TYPE OF LEAVE TO BE AVAILED OF					6.B DETAILS OF LEAVE
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11			Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292)				In case of Vacation/Special Privilege Leave:
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13			Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292)					Within the Philippines __________________________
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15			Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292)					Abroad (Specify) _____________________________
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17			Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS)				In case of Sick Leave:
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19			Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended)					In Hospital (Specify Illness) _____________________
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21			Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292)					Out Patient (Specify Illness) ____________________
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23			Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004)				_____________________________________________
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25			Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292)				In case of Special Leave Benefits for Women:
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27			10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005)				(Specify Illness) ________________________________
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29			Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292)				_____________________________________________
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31			Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010)				In case of Study Leave:
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33			Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended)					Completion of Master's Degree
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35			Adoption Leave (R.A. No. 8552)					BAR/Board Examination Review
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37							Other purpose:
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39		Others:						Monetization of Leave Credits
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41		_____________________________________						Terminal Leave
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43	6.C NUMBER OF WORKING DAYS APPLIED FOR					6.D COMMUTATION
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45		________________________________________						Not Requested
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47			INCLUSIVE DATES					Requested
48		________________________________________
49						(Signature of Applicant)
50		7. DETAILS OF ACTION ON APPLICATION
51	7.A CERTIFICATION OF LEAVE CREDITS					7.B RECOMMENDATION
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53			As of _______________________					For approval
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55				Vacation Leave	Sick Leave			For disapproval due to ________________________
56			Total Earned					___________________________________________
57			Less this application					___________________________________________
58			Balance					___________________________________________
59								___________________________________________
60			Acting HRMO Head			(Authorized Officer)
61	7.C APPROVED FOR:					7.D DISAPPROVED DUE TO:
62			_______ days with pay					_______________________________________
63			_______ days without pay					___________________________________________
64			_______ others (Specify)					___________________________________________
65	_________________________________ Chancellor II
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