CSC Form No.

6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( x) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 3, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates June 30, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( x) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 3, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates June 30, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave
Name Consuelo O. Paramio (x) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 3, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates July 4, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio (x ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 3, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates July 4, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave
Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 17, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates April 28, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 17, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates April 28, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio (x ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 18, 2017 ( ) Special Leave
No. of Working Days Applied for: 5 days ( ) Others
Inclusive Dates July 21 – 27, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio (x) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 18 2017 ( ) Special Leave
No. of Working Days Applied for: 5 days ( ) Others
Inclusive Dates July 21, 2017 - July 27, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 20, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates June 9, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( x) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File July 20, 2017 ( ) Special Leave
No. of Working Days Applied for: 1 day ( ) Others
Inclusive Dates June 9, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File ( ) Special Leave
No. of Working Days ( ) Others
Inclusive Dates
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( x) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File ( ) Special Leave
No. of Working Days ( ) Others
Inclusive Dates
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File December 11, 2017 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates November 2, 2017
 ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File December 11, 2017 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates November 2, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File December 11, 2017 (x ) Special Leave
No. of Working Days 2 days ( ) Others
Inclusive Dates December 8 & 15, 2017
ACTION ON APPLICATION
Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary ( ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File December 11, 2017 (x ) Special Leave
No. of Working Days 2 days ( ) Others
Inclusive Dates December 8 & 15, 2017
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor
Date :_______________
CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio (x ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File January 19, 2018 ( ) Special Leave
No. of Working Days 4 days ( ) Others
Inclusive Dates January 17, 2018 (Sick Leave)
January 24-26, 2018 (VL)
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio (x ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File January 19, 2018 ( ) Special Leave
No. of Working Days 4 days ( ) Others
Inclusive Dates January 17, 2018 (Sick Leave)
January 24-26, 2018 (VL)
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________
CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File August 10, 2018 ( ) Special Leave
No. of Working Days 2 days ( ) Others
Inclusive Dates August 6 and 7, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File August 10, 2018 ( ) Special Leave
No. of Working Days 2 days ( ) Others
Inclusive Dates August 6 and 7, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________
CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File September 10, 2018 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates September 6, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File September 10, 2018 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates September 6, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________
CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File October 1, 2018 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates September 19, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________

CSC Form No. 6 (Revised 1997) APPLICATION FOR LEAVE

Signature Type of Leave

Name Consuelo O. Paramio ( ) Vacation ( ) Within the Philippines
Position MPDC ( ) Abroad
Monthly Salary (x ) Sick ( ) Out Patient
Office/Division MPDC ( ) Maternity
Date of File October 1, 2018 ( ) Special Leave
No. of Working Days 1 day ( ) Others
Inclusive Dates September 19, 2018
ACTION ON APPLICATION

Commutation: Recommending:

( x ) Requested ( ) Not Requested

QUIRINA T. SARTE
Municipal Mayor

( ) Approval ( ) Disapproval due to ________________________

FOR PERSONNEL USE ONLY:

Leave Credits as of VL SL TOTAL

Less: This Leave

Leave Balance
( ) Approved for : ( ) Disapproved due to
__________________
_______ Days with pay
_______ Day without pay

Certified by: Approved:

MEDIATRIX T. GUTIERREZ QUIRINA T. SARTE

Supervising Administrative Officer Municipal Mayor

Date:________________