Application for Leave
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Republic of the Philippines
DEPARTMENT OF AGRICULTURE
Cordillera Administrative Region
BPI Compound, Easter Road, Guisad, Baguio City
Stamp of Date of Receipt
APPLICATION FOR LEAVE
1. OFFICE/DEPARTMENT
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2. NAME :
3. DATE OF FILING
4. POSITION
5. SALARY
6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF
Vacation Leave
(Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Mandatory/Forced Leave
(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No.292)
Sick Leave
(Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Maternity Leave
(R.A. No. 11210/IRR issued by CSC, DOLE and SSS)
Paternity Leave
(R.A. No. 8187/CSC MC No. 71, s. 1998, as amended)
Special Privilege Leave
(Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
Solo Parent Leave
(RA No. 8972/CSC MC No. 8, s. 2004)
Study Leave
(Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292)
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)
Special Emergency (Calamity) Leave
(CSC MC No. 2, s. 2012, as amended)
Adoption Leave
(R.A. No. 8552)
Others:
6.B DETAILS OF LEAVE
In case of Vacation/Special Privilege Leave:
Within the Philippines
Abroad (Specify)
In case of Sick Leave:
In Hospital (Specify illness)
Out Patient (Specify illness)
In case of Special Leave Benefits for Women:
(Specify illness)
In case of Study Leave:
Completion of Master's Degree
BAR/Board Examination Review
Other purpose:
Monetization of Leave Credits
Terminal Leave
6.C NUMBER OF WORKING DAYS APPLIED FOR
INCLUSIVE DATES
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6.D COMMUTATION
Not Requested
Requested
Division Chief (2nd Signatory)
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ATTACHMENTS
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Please upload required attachments for the type of leave (e.g., medical certificates, travel documents, etc.)
Accepted formats: PDF, DOC, DOCX, JPG, JPEG, PNG, GIF (Max 10MB per file)
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