Republic of the Philippines

Department of Justice
Bureau of Corrections
LEYTE REGIONAL PRISON
Abuyog, Leyte

APPLICATION FOR LEAVE

CSC FORM No. 6
Revised 1984
__________________________________________________________________________________________________
OFFICE/AGENCY NAME (Last) (First) (M.I.)
BUREAU OF CORRECTIONS EDLOY WILBERT J.
__________________________________________________________________________________________________
DATE OF FILING POSITION SALARY (Monthly)
SEPTEMBER 22, 2017 PRISON GUARD 1
DETAILS OF APPLICATION
TYPE OF LEAVE WHERE LEAVE WILL BE SPENT
( ) Vacation ( ) IN CASE OF VACATION LEAVE
( ) To seek employment ( ) Within the Philippines
( ) Others (Specify)__ _______ ( ) Abroad (Specify)

( ) Sick ( ) IN CASE OF SICK LEAVE

( ) Maternity ( ) In Hospital (Specify)
( ) Others (Specify) ________________________________
Forced Leave ( ) Out-Patient (Specify)
___________________________
NO. OF WORKING DAYS APPLIED
For: 5 DAYS COMMUTATION
Inclusive Date: OCTOBER 2, 3, 4, 5, 6, 2017 ( ) Requested
( ) Not requested

PGI JOSE P. ESTONILO Jr.

SUPERVISOR