Form6hs (Forelem)
Form6hs (Forelem)
Form6hs (Forelem)
Revised 1984
APPLICATION FOR LEAVE
1. AGENCY : 2. NAME (LAST) (FIRST) (MI)
__________________________________DETAILS OF
APPLICATION_______________________________
6.a)TYPE OF LEAVE 6.b) Where leave will be spent?
1. IN CASE OF VACATION LEAVE
: _________________________
__________________________________________:_____________________Signature of Applicant________
________________________DETAILS OF ACTION ON APPLICATION_____________________________
CERTIFICATION OF LEAVE CREDITS : 7. b-RECOMMENDATION
As of ________________ : _____________________ Approved
_______________________________________ : /____________________/
Vacation : Sick : Total : _____________________ Disapproval due to
_______________________________________ : /____________________/
Days : Days : Days :
:
_______________________________________ :
_________________________
: Authorized Official
__________________________________________:
_____________(Personnel Officer)_____________________________________________________________
APPROVED FOR : 7. d-DISAPPROVED DUE TO
_____________________________
Signature
_____________________________
Authorized Official
NOTE:__________________________