Leave Form

FMB application form for leave

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: APPLICATION FOR LEAVE
1.

OFFICE/AGENCY

2.

NAME (Last, First, Middle)

4.

POSITION

Forest Management Bureau
3.

DATE OF FILING

6.

5.

DETAILS OF APPLICATION
6.A. TYPE OF LEAVE

SALARY (Monthly)

6.B. WHERE LEAVE WILL BE SPENT
1. IN CASE OF VACATION LEAVE

Vacation

Within the Philippines

To seek employment

Abroad

Others

(Specify)

(Specify)
2.

IN CASE OF SICK LEAVE

Sick

In Hospital

Maternity

(Specify)

Others

Out-Patient

(Specify)

(Specify)

6.C. NUMBER OF WORKING DAYS APPLIED

6.D. COMMUTATION

FOR:

Requested

Not requested

INCLUSIVE DATES
Signature of Applicant
7.

DETAILS OF ACTION ON THE APPLICATION
7.A CERTIFICATION OF LEAVE CREDITS
As of

7.B. RECOMMENDATION

Approval
Vacation

days

Sick

days

Total

days

Personnel Officer

Disapproval due to

Immediate Supervisor

7.C. APPROVED FOR

7.D. DISAPPROVED DUE TO:
day(s) with pay
day(s) without pay
others (Specify)

(SIGNATURE)
(AUTHORIZED OFFICIAL)
Date:
2017/fppkmd-kiss/eve