Application and Leave Forms

A Group Activity
presented to Mr. Richard Perez

In partial fulfillment of the requirements in

Governance, Business Ethics,
Risk Management and Internal Control

By

Crissy Lean C. Canillas

April Rose C. Dacilio
Lauren Yve P. Decibar
Nicole B. Diaz
Karen Cone Labis
Joshua D. Mandocdoc
Gennica D. Martinez
Abby Marileth M. Umipig
Krizia Mae C. Villamor

January 2021
 APPLICATION FORM

PERSONAL INFORMATION

Last Name First Name M.I.

Present Address:

Building No. Street City Province Zip Code

How long do you plan on working here? SSS No.
Contact No.: If under 18, please list age:
Position Applied for: Salary Desired:
How many hours can you work weekly? Can you work nights?

Employment Desired:

When available for work?

EDUCATION & OTHER INFORMATION

NO. OF YEARS MAJOR &
TYPE OF SCHOOL NAME OF SCHOOL LOCATION COMPLETED DEGREE

HIGH SCHOOL

COLLEGE

BUSINESS & TRADE

SCHOOL

PROFESSIONAL SCHOOL

REFERENCES

NAME TITLE COMPANY CONTACT NO.

 ACKNOWLEDGEMENT AND AUTHORIZATION

I certify that all answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in
arriving an employment decision.
In the event of employment, I understand that false or misleading information given in my application or
interview(s) may result in discharge

______________________________ _________________
SIGNATURE OVER PRINTED NAME DATE
MEMO
TO: Electronica Employees
FROM: Human Resources Department
SUBJECT: Changes in Human Resource Policy and Additions
DATE: January 2021

Introduction:

Body:

Conclusion:

Thank you for your cooperation,

Human Resources
OVERTIME AUTHORIZATION FORM
No one may be paid for overtime unless this form has been completed and with prior approval of the
supervisor. Overtime is paid only when there are hours worked in excess of 40 during a workweek.
EMPLOYEE NAME JOB TITLE EMPLOYEE ID DATE FORM COMPLETED

IMMEDIATE SUPERVISOR DEPARTMENT HOURLY RATE OF PAY

₱0.00

DATE OF OVERTIME WORK TIME OF OVERTIME WORK

START DATE END DATE START TIME END TIME

ANTICIPATED NUMBER
0.00
OF OVERTIME HOURS

Reason for requested overtime:

APPROVAL
SUPERVISOR SIGNATURE DATE OF APPROVAL HR REP SIGNATURE DATE OF APPROVAL

INSTRUCTIONS
No overtime will be paid unless this form has been completed prior to overtime. In the event of an emergency,
the form must be completed within the week of the overtime worked.
It is the responsibility of the employee to submit a signed timesheet for specific overtime work. The employee
must do this before payroll is completed. The form must be returned to the immediate supervisor.
Employees are required to maintain individual time records of hours worked on a weekly basis.

Working extra hours without the approval of the supervisor may become grounds for disciplinary action.
 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

Application for Paternity Leave

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section 2 – Type of Paternity Leave

While leave is expressed in weeks, it will be administered in average hours based on the employee’s normal work week.
This leave must be taken within 12 weeks of the date of the event.

Birth Month (Pregnancy Confirmation Form will also need to be completed)

Non-birth Parent

Birth Adoption Foster Care

Child Expected Date of Birth/ Adoption or Placement: ______________________________________________

Relation with the Child: _____________________________

I am requesting a paternity leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received my approval for
the request for self-explanatory reasons.

Supervisor Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

Application for Maternity Leave

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section 2 – Type of Maternity Leave

While leave is expressed in weeks, it will be administered in average hours based on the employee’s normal work week.
This leave must be taken within 12 weeks of the date of the event.

Birth Month (Pregnancy Confirmation Form will also need to be completed)

Non-birth Parent

Birth Adoption Foster Care

Child Expected Date of Birth/ Adoption or Placement: ______________________________________________

Relation with the Child: _____________________________

I am requesting a maternity leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received my approval for
the request for self-explanatory reasons.

Supervisor Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

Application for Paid Parental Leave

EMPLOYEE
(Read reverse side for requirements)
Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section 2 – Type of Maternity Leave

While leave is expressed in weeks, it will be administered in average hours based on the employee’s normal work week.
This leave must be taken within 12 weeks of the date of the event.

Birth Month (Pregnancy Confirmation Form will also need to be completed)

Non-birth Parent

Birth Adoption Foster Care

Child Expected Date of Birth/ Adoption or Placement: ______________________________________________

Relation with the Child: _____________________________

DURATION OF ABSENCE: (all employees should fill out)

Date(s): _________________ TOTAL DAYS PAID: _____________ TOTAL HOURS PAID:______________

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received my approval
for the request for self-explanatory reasons.

Supervisor Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

Application for Service Incentive Leave

EMPLOYEE
(Read reverse side for requirements)
Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section II – REASON FOR SERVICE INCENTIVE LEAVE

The employee must be pre-approved for the leave. Indicate the reason for the request:

Please indicate your reason for Vacation Leave below and submit an explanation to support your request.

 1. Personal reason
 2. Time-off for vacation
 3. Personal illness (in lieu of sick leave)
 4. Other: ______________________

a. Every employee who has rendered at least one (1) year of service shall be entitled to a yearly service incentive leave
of five (5) days with pay.

b. This provision shall not apply to those who are already enjoying the benefit herein provided, those enjoying vacation
leave with pay of at least five days and those employed in establishments regularly employing less than ten employees
or in establishments exempted from granting this benefit by the Secretary of Labor and Employment after considering
the viability or financial condition of such establishment.

I am requesting a service incentive leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received my approval for
the request for self-explanatory reasons.

Supervisor Signature Date

 Office Use

Year(s):
(Deadline for application to be received in Pending:
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

APPLICATION FOR BEREAVEMENT LEAVE

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Degree Achieved ___________________________________________________________________________

Section II – REASON FOR BEREAVEMENT LEAVE

All full and part-time employees of Electronica Company are entitled to unpaid bereavement leave in the event
of the death of a family member or friend. Bereavement leave will not count against time taken for vacation or
sickness.

Please indicate the reason of Bereavement Leave applied below.

 1. Bereavement leave for Immediate Family (Spouse, children, parents, and in-laws)
 2. Bereavement leave for Non-Immediate Family (Aunts, uncles, cousins, etc.)
 3. Bereavement leave for Friends/Co-workers, etc.

I am requesting a professional bereavement leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received
satisfactory evaluations and is not being considered for documentation.

Supervisor Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

APPLICATION FOR VACATION LEAVE

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section II – REASON FOR VACATION LEAVE

The employee must be pre-approved for the leave. Indicate the reason for the request:

Please indicate your reason for Vacation Leave below and submit an explanation to support your request.
 1. Personal reason
 2. Time-off for vacation
 3. Personal illness (in lieu of sick leave)
 4. Other: ______________________

I am requesting a vacation leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received
satisfactory evaluations and is not being considered for documentation.

[Title] Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

APPLICATION FOR SICK LEAVE

(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section II – REASON FOR SICK LEAVE

Employee regardless of their position level, regular employees are entitled to ten (10) days of sick leave every
year starting on the date of the regular appointment of an employee or upon reaching one’s 6th month of service.
Acceptable reasons during said leave include, but are not limited to:

Please indicate your reason for Sick Leave below and submit an explanation to support your request.
 1. Illness/injury/incapacitation of requesting employee
 2. Care of family member, including medical/dental/optical or bereavement
 3. Medical/dental/optical examination of requesting employee
 4. Other: ________________________

I understand that:
1. Sick leave must be approved by the Supervisor or Department head.
2. If the sick leave is more than three (3) days, a fit-to-work certificate from the doctor is needed in order to go
back to work and
3. Alteration/Cancellation of applied leave must have the approval of the Supervisor or Department Head and
must be properly notified.

I am requesting a sick leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received
satisfactory evaluations and is not being considered for documentation.

[Title] Signature Date

 Office Use

Year(s):
(Deadline for application to be received in Pending:
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

APPLICATION FOR SPECIAL EMERGENCY LEAVE

(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section II – REASON FOR SPECIAL EMERGENCY LEAVE

Employee filed leave for special milestone and/or attend to filial and domestic emergencies including special
gathering, mourning, etc. Acceptable reasons during said leave includes, but are not limited to:

Please indicate your reason for Special Emergency Leave below and submit an explanation to support your
request.
 1. For urgent repair and clean-up of damaged house, being stranded in affected areas.
 2. Disease/illness of employees brought by natural calamity/disaster.
 3. Caring of immediate family member(s) affected by natural calamity/disaster.
 4. Others: _________________________

I understand that:
1. Special emergency leave must be approved by the Supervisor or Department head.
2. Planned leave application of three (3) days or more must be filed five (5) days upon returning to work.
3. Alteration/Cancellation of applied leave must have the approval of the Supervisor or Department Head
and must be properly notified.

I am requesting a special emergency leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received
satisfactory evaluations and is not being considered for documentation.

[Title] Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

Application for Rehabilitation Leave

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Section II – REASON FOR REHABILITATION LEAVE

The following leave shall only be allowed in case of accidents related to their work performance. The employee
must be pre-approved for the leave. Indicate the reason for the request:

Please indicate your reason for Vacation Leave below and submit an explanation to support your request.
 1. Accident while performing duty
 2. Accident on the way to work
 3. Accident during official travel, authorized overtime and special assignment orders
 4. Other: ______________________

I am requesting a rehabilitation leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received my approval for
the request for self-explanatory reasons.

[Title] Signature Date

 Office Use

Year(s):
Pending:
(Deadline for application to be received in
(Date) Application Received Date: ________________ Approved:
Denied:
Letters:

APPLICATION FOR LEAVE DUE TO GYNECOLOGICAL DISORDERS

EMPLOYEE
(Read reverse side for requirements)

Section 1 – General Information

Name ____________________________________________ Personnel No. ____________________________

(Last) (First)
Home Address _____________________________________ Home Phone _____________________________

__________________________________________________ Work Phone _____________________________

(State) (Zipcode)
Present Job Position/ Worksite _________________________ Years of Work Experience __________________

Degree Achieved ___________________________________________________________________________

Section II – REASONS FOR LEAVE DUE TO GYNELOGICAL DISORDER

Any female employee, regardless of age and civil status, shall be entitled to a special leave for a maximum of two
(2) months with full pay provided she has rendered at least six (6) months aggregate service in any various
government agencies for the last twelve (12) months prior to undergoing surgery for gynecological disorders.

I understand that:
1. Leave due to gynecological disorders application form must be approved by the Supervisor or Department
head.
2. The special leave benefit may be filed in advance, at least five (5) days for the government sector, or
within a reasonable period of time prior to the scheduled date of gynecological surgery for the private sector.
In case of emergency surgical procedure, the said leave shall be filed immediately upon the employee’s
return from such leave.
3. Alteration/Cancellation of applied leave must have the approval of the Supervisor or Department Head
and must be properly notified.

I am requesting a gynecological leave commencing ___________ until ___________.

Employee's Signature Date

By signing this recommendation, I am verifying that while under my supervision, this employee has received
satisfactory evaluations and is not being considered for documentation.

[Title] Signature Date