CHIEF DIRE CTORIAL STAFF

Document Nu
22-00698

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Republic of the Philippines
Received From
Date/Time
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Department of the lnterior and Local Govemment
BUREAU OF FIRE PROTECNON
DILG NATIOTAL HEADOUARTERS
Agham Road, Barangay Bagong Pag-asa, Quezon City
Telefax Number (O2) 426 - M7
Email: cdsnhql 235@qmail.com

MEMORANDUM

TO ALL REGIONAL D]RECTORS

Regions l-12, CAR, CARAGA, BARllt{, and NCR
Director, NFTI

ATTN: Ghief, Administrative Division

SUBJECT: Civil Servlce Form No. 6 Revised 2020

Application for Leave

DATE: 22February 2O22

1 . References
a. CSC Memorandum Circular No. 5 s. 2021 Amendment to
Omnibus Rules on Leave (CSC MC No.41, s. 1998, as
amended);
b. CSC Memorandum Circular No. 8 s. 2021 re'. Clarification on
the Use of CS Form No. 6, Revised 2020; and
c. Department Circular No. 20'18-29 dated 09 November 2018
re: Amendment to Circular 201 8-18 re: Delegation of
Authority- lnterior Sector

2. The Civil Service

Commission (CSC), in its Memorandum Circular No. 5 s.
2021 , Amendment to Omnibus Rules on Leave (CSC MC No. 4'l , s. 1998, as amended)
states:

"All employees shall use the prcscribed rcvised Application for Leave Form
(Civil Seruice Form No. 6, Revised 2020) with the lnstructions and
Requirements found in Annex A and the Notice of Allocation of Maternity
Leave (CS Form No. 6a, s.202O) found in Annex B as applicable".

3. Relative thereto, direct all personnel under your respective jurisdictions to use the
revised Application for Leave Form (Civil Service Form No. 6, Revised 2O2Ol, copy
of which is attached for reference. Forms can also be downloaded from the CSC
official website (csc. gov.ph).

4. For uniformity of identifying the authorized signatories, we recommend to observe

the below enumerations, which is consistent with our approved Delegation of
Authority:

a. For Leave of Absence within the Authority of the Municipal Fire Marshal/
City Fire Director/District Director (7days), Provincial Director (15 days),
Regional Director (30 days)

ISO 9001:2015
CERTIfIED O UALITY
stsTtll
 7. Detaib of Action on Authorized Ofhcer/Official
Application
7.A Certification of Leave Credits Admin NCO/Staff

7,B Recommendation Chief, Admin

7.C Approved for MFM/CFD/PD/DD/RD

7.D Disapproved due to MFM/CFD/PD/DD/RD

b. For Leave of Absence within the Authority of the Chief, BFP sixty (60) days:

Details of Action on Application Authorized Offi cer/Official

7.A Certification of Leave Credits Chief, Administrative Division

(Region)

7.8 Recommendation Regional Director

7.C Approved for Chief, BFP

7.D Disapproved due to Chief, BFP

c. For Leave of Absence within the Authority of the Undersecretary for Public
Safety (USPS)/Secretary, DILG (SILG), exceeding sixty (60) days:

Details of Action on Application Authorized Officer/Official

7.A Certification of Leave Credits Chief, Administrative Division
(Region)

7.B Recommendation Chief, BFP

7.C Approved for USPS/SILG

7.D Disapproved due to USPS/SILG

5. Be informed however, that as of this date, only Matemity, Paternity, and Sick
Leave applications are allowed for processing.

6. For information and widest dissemination.

BY COII'MAND OF THE CHIEF, BFP:

P RNANDEZ, CESE
(DSC) BFP
Ghief Directorial Staff
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ISO 9001:2015
CERTIfIED OUALITY
MAIIAGEYTITTSYSIEM
Cirlsrvr.. Forr I.' a

Republic of the Philippines

Departsnent of the lnterior and Local Government
BUREAU OF FIRE PROTECTIO
ACrEm Road, Silb Srt Ro$re. argy B{p.lg Pa&asa. A|Ezon Ciy

APPLICATION FOR LEAVE

1, OFFICE/D€PARTM€NT (L8st) (Middl€)

3 OATE OF FILING 4 FOSmON 5 SAIARY

6. DETAILS OF APPLICATION
6.A ryPE OF LEAVE TO 8E AVAILED OF DETAILS OF LfAVE

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INCLUSIVE DATES
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7. DETALS OF ACNON ON APPUCATIOT{

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7,C APPRO\/ED FOR: 7D DISAPPROVED Ot'E TO

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 INSTRUCTIONS AND REQUIREMENTS
Applicalih for any lype of lee\€ lhdl be nde on thb Fqm and lo be acco.npltsH d ln the abcence oa the BPOTfTPO/PPO o. t,le cerlifcatirn, a pdice
at leesi h e.dicab wim dcxrE rE y requirenleoB, as 6id,s: eooaf spe<rryilg t€ d€laib of the occunerrce c, virl€nce on tlE virm
and a medical cerlifcate may be consirercd, at the discreton of the
l. VacSon loaw' irnrnediate supervisor of the woman emplcryee cmcemed.
It shall be 6led fi\re (5) days in advanc6, *fler|ever pcssibb, of Ule efiedive date of
sudl leave. Vacslron lea\€ within in th€ Pn ipdrEs or abroed ihall be irldi€bd in the 10. Rotaufltadon learg - up to 5 modna
iorm br porpo€€s ol seoriaE t',t,el aumdity and coll|PletirE dear5rce noan monery . Apdi(rion shall be made within one (1) 'lle€k frorn the time 0d tlE
alld wk accouniatiliti.)s. a.filent excert wllei a bnger p€{i, b x,arrafiEd.
. LetEr Equest s.ppqEd by rd6/-a lepo.ts slrdt as tle pdice repdt if
2. f, aodato.y/FoErd loave av.
Annual fiveiay vacalbn leave shall be forEited if nol taken du.ing the year. ln case . Medical certificate on the natuleoffie injuries, fle couGe of trealrnent
the sdEduled leave has been cancelled h the erb€ocy of the servire by fle head of invohred, and the need to undergp rcst Ecuperaton, and lehabilitalio.l,
agency, n shell no lo.tser be dedrded fro.n th€ acamulated vacajoa leave. as tl|e case rnay be.
Araillner of or|e (1) day or more Vacaibn Leave (VL) shall be consir€red tor . Wdtten cooorarence of a gov€mmenl ptrFhlan shorld be obtaia!€d
co.nplyiE tle marxratory/forced h:ve sutiect b the co.dnirrE under Seclbn 25, Rub relali\c lo lhe recomrnendalion lor lehauliblton if the atterding
I\vl ofthe Ornnibus Rules lmplemenlillg E.O. !ao. 292. physician is a p.ivaE pracrlions, pdticrilar, on the duratioo ot til€
le.ird of rehatilita&xl.
l. Sk* leave'
. lt shdl be fled imm€diably upoi employee's retum fro.n $crr leave. 11. Sp.cLl loaw berEftr for wornen' - up to 2 modth!
. lf in advance or exceedaog frve (5) days, apptdlrr sha be accomponred by a 'The applicalion may be fl€d an advance, thet is, at least nve (5) days
fbd
medical certificate. ln case medhal coflsulleti$ was not availed ot, an afrdavil should pdor to the scheduled date of lhe gynecolooical surgery that vrill be
be ex€q$ed bV an epplicant undergone by the employee. ln case of emeeeo(ry, the applir-tion for
special leave shall be filed amrn€diately upon employee's.efum but
a. Lt
?r t, Lq,.t - 105 dlF during corifnernert tle agerE'y stlall be nolifed of sai, slrgery
. Proof ol p{eonarEy e.g. u|tsasound, clocbas cerlillcate m rle eceecied dab of . The applirbn sha$ be efnpanied by a m€di=l certificate fled out
detirre.y by the prop6 rnedi:al adnoriti€s, e.g. the dtendiig $rg€on
. AcEdndi6hed Nolbe of Allocation of i,latemity Leave Credits (CS Form No. 6a), if accompanid by a dinical summary reffecting the gynecolo€ical disorder
needed ,dt ch shall be addEssed or was addressed by the sard surgery; the
- Second€d Crnale emplq,ees stlall eniry maternity l6ve with full pay in tE recident histopattrolrqical report; tle operative tedrnhue used for the surg€ry;
aadq. the duratirl d the sueery indrrdir€ f€ perbperatj'/e peri, (pedod of
coifine.ient aroond suroery); as rlell 6 the emplqre€s edimated period
5. Pabrnity b.E - 7 dayg of ecuperalioo fur the same.
Proofof ct ld's delivery e.g. lir$ certifcate, riedical ce.tificab and mani ,gE cont"acl
{2. Spochl ErErgerEy (C.lamily) l€3rp - up fo 5 d.yr
6. Special hvlloge have - I daF . The special emerEencf leave can be apphed fo( a maximum of fve (5)
I shall be filedlapproved for at l€asf one (1) vr€e* prior lo availmefit excepl on straight wDrking daF or staggered basis wrthin $iny G0) daF frorn the
emergiency €ses. Specjal pdvilege leave wihin the Philippines or abrcad shall be actual oconreflce of the natuGl calamity/disasE. Sak, privilege shall be
indiceH in the form lor purpos6 of s€Grnng feve{ authority aod completing enjq/ed once a year, not in every instance of calEmily or disaster
clearance liom money ard v,ork accountabilities. . The head of otrce shafl take full resporEibility b{ tle g6nf of special
errle€eltcl leave and yeriFr.lim of the emplq/ee's elilibility to be
7. Srolo Prrtlrt baYe - 7 drra grar ed her€of. Sirid verinirbn shail indde: vdiratirr c, dace d
It shal be fl€d in advame q wlt€never pGsibb ltlrc (5) days belore gEing o.r $clt rqsirence bas€d dl lale6t availabb reco{(l3 of t}E afieded €mph/re;
leave wilh updaied Solo Palelrt ldenlifcation Cad. verifcation that the place of residence is covered in the declaration of
calamity area by the proper govemment agencyi and such other pools
8. Strdy b.v.'- up b 6 nodn! es may be necessary.
. shdl rnea{ fi€ agEnqrs ,ntefial equkefteits, if anyi
. Coifad b€t ,en dle agsrcy head or auhorized epreaentalive ard rte €rnplotEe 13. Iio.l&tiqr ot loave credit3
coccemed. Appli:alioo b{ ,ndr€ltizaLo c, fifiy percern (50%) o( more of tle
acofiulaled leave crediE shalt be accornpani€d by hiter requesl b the
9. VAIrc bavo - t0 dry. h€ad of the agerEy staling tlle valid ard jwtifabb rcasons.
. h shall be fled in advance or imr|ediab{y upori the u/ornan emplq/ee's r€t m ftorrl
sJdr l€w. l,a. Terml.El l€ev€'
. lt shal be accornpaniql by any of the blloxing $Dpo.6ng dodmentsl Proof ol emplo)€e s resigmlixr or reltr€rnent or separation lrorn tlre
a. BararEay Proteclion Order (BPO) otxain€d fro.n Ule barangaf
b. Temporary/Pemanern Pr&clion Order ([PO/PPO) obtain€d trom the court
c' f the poteclton order is not yct is$red by t€ bararEey or the court a ceft'@iion It A@or Leavo
i&qred bylie Puno.E Bar g8y/K4a$€d or .Apdicalirn br adodbn l6ave shall be il€d rith a. arth€olicated cofy
Prose.rrtor o. the Clerl d Cont tEt tre apdi:alioi fu. lhe 8PO, TPO o. PPO ha3 d tE Hdopt !e PlecerrEnl Altrcoty iseed by tE Depertnefit d
ben fled wi$ fle sau otrce shall be sufficbnt to support fle eppli:atbn br l'|e len- Socaal Wefare and Developrnern (DSWD)
day leave: or

'For leave of abc€ice for t$dy (30) caMr days or hore a.ld terminal leave, apdicalbn shall be acao.ngenied by a cl€arance tro.n rtoney.
p.opeo and '.ort<related eountabililies (pursuarn to CSC irientorardum Cirorhr t{o. 2, s 1985).