APPLICATION FOR LEAVE

1. OFFICE/AGENCY

2. NAME (LAST)

LIBACAO POLICE STATION

3. DATE OF FILING

TORDECILLAS
4. POSITION

(FIRST)

DENNIS

(MIDDLE)

TORCUATOR
5. MONTHLY SALARY

02 FEBRUARY 2009

DESK OFFICER/JAILER/DRIVER PNCO P 10,635.00

DETAILS OF APPLICATION
6. A) TYPE OF LEAVE
6. B) WHERE LEAVE WILL BE SPENT
1. IN CASE OF VACATION LEAVE
(x) Within the Philippines
(X) Vacation
( ) Abroad
( ) To seek employment
( ) Other (Specify)
( ) Force Leave
( ) Sick
( ) Maternity
6. C) NUMBER OF WORKING DAYS
APPLIED FOR
15 DAYS___
16 FEBRUARY 09 MARCH 2008

2. IN CASE OF SICK LEAVE

( ) In Hospital (Specify) ______________
( ) Out Patient (Specify) ______________
_______________________________
6. D) COMMUTATION
(x) Requested
( )
PO2 DENNIS T TORDECILLAS
(Signature of Employee)

DETAILS OF ACTION ON APPLICATION

7. A) CERTIFICATION OF LEAVE CREDITS
7. B) RECOMMENDATION FOR
AS OF 31 October 2008
( ) Approval
( ) Disapproval due to ________________
Vacation = Sick = Total
Balance
58.125 = 88.125 = 146.250
Less this Leave 15.000 = ______ = 15.000
Balance
43.125 = 88.125 = 131.250
Days
Days
Days
INSP RENATO J JAIME
Chief of Police

7. C) APPROVED FOR:
______________ Days with pay
______________ Days without pay
______________ Others (Specify)

P/SSUPT CLARENCE V GUINTO

Provincial Director

7. D) DISAPPROVED DUE TO:

_______________________________
_______________________________
_______________________________

______________________________________
(Authorized Officer)

________________________