Civil Service Form No.
6
Revised 2020
Republic of the Philippines
Department of Education
Division of Bayugan City
APPLICATION FOR LEAVE
1. OFFICE/DEPARTMENT 2. NAME: (Last) (First) (Middle)
DEPED GABAIS, JONATHAN FUNDAL
3. DATE OF FILING:February 2, 2026 4. POSITION:TEACHER I (JHS) 5. SALARY:342,144.00
6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE
Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
In case of Vacation/Special Privilege Leave:
Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines __________________________
Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify) _____________________________
Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS)
In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended)
In Hospital (Specify Illness) _____________________
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness) Fever
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004)
In case of Special Leave Benefits for Women:
Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
(Specify Illness) ________________________________
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005)
_______________________________________________
Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) In case of Study Leave:
Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) Completion of Master's Degree
BAR/Board Examination Review
Adoption Leave (R.A. No. 8552)
Wellness Break Other purpose:
Others: Monetization of Leave Credits
Terminal Leave
______________________________________
6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION
2 DAY/S Not Requested
INCLUSIVE DATES Requested
JAN 29, 2026, JAN 30, 2026
Gabais, Jonathan Fundal
7. DETAILS OF ACTION ON APPLICATION
7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION
As of February 2, 2026 For approval
For disapproval due to _______________________
Service Credit
______________________________________________
Total Earned 7
______________________________________________
Less this application 2 ______________________________________________
Balance 5
DOLORITO, RONALD VILLAMOR
Madelo, Lucille Hurboda
7.C APPROVED FOR: 7.D DISAPPROVED DUE TO:
2 days with pay __________________________________________________
0 days without pay __________________________________________________
________ others (Specify) __________________________________________________
Roa, Corazon Pajarillo
(This is a system generated form)