Division of Pasig City

City of Pasig
School District 1, Pasig 1
NAGPAYONG ELEMENTARY SCHOOL

August 1, 2013

The Asst. Schools Division Superintendent

Officer-In-Charge
Office of the Schools Division Superintendent
Division of Pasig City
Pasig City

Madam:

I have the honor to submit herewith the following pertinent papers for ERF evaluation for
Teacher II.

1. Equivalent Record Form

2. Notarized Sworn Statement
3. Permit to Study
4. Original and Xerox copies of Transcript of Records
a. BEED
b. Masteral
5. Service Record

Very truly yours,

________________________________
Teacher I

1st Endorsement
Nagpayong Elementary School
August 1, 2013

Respectfully forwarded to the Assistant Schools Division Superintendent, Officer-In-Charge,

Division of Pasig City, through the Coordinating Principal, District I, Pasig I, the pertinent papers of
___________, contents noted and recommending favorable action.

________________________________
Principal
___________________
Coordinating Principal
 Republic of the Philippines
Department of Education
National Capital Region
Division of Pasig City
District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL
School

EQUIVALENT RECORD FORM

NAME: _______________Date of Birth: ____________ Employee No: ____________

Authorized Position Title: Teacher 2 Form No._____________ PSI HP Blg. _________
Authorized Salary: __________Item No.: _______________________ CY: __________

I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:

Title, Degree or Name of Institution Year Civil
Highest Grade Received Service Rating Date of
Examination
Attained Eligibility

II. SERVICE RECORDS (Attached Duly Certified Service Record)

III. EQUIVALENT UNITS:
A. Total No. of year in Teaching: (Public Only) __14 years Equivalent ______
B. Degree to Degree Equivalent _____ _ Equivalent ______
C. Areas of Equivalent: School Year: No. of Units: Description:
1. Professional Study __2001-2013 51 MAED. Educ. Management
2. Teaching Experiences
a. Public Schools __1999 to present__-14 years
b. Private Schools 1998-1999 – 1 year
3. Admin. Supervisory Experience
a. Public School _________NA___________
b. Private Schools _______ NA __________
4. Others: (Seminars, Workshop, etc.) (See attached page)
TOTAL: _________________

___ARLENE S. CAGUNOT
________________ Teacher’s Signature
Principal CELIA C. PAULINO
Coordinating Principal

LATEST EFFICIENCY RATING: VS School: Nagpayong Elementary

NOTE: Teachers DO NOT WRITE BELOW District: I, Pasig I
IV. Division Action Date Range Salary Salary
Processed Assignment Range Schedule REMARKS

RECOMMENDING APPROVAL:

________________________
Asst. Schools Division Superintendent
Officer – In - Charge

V. DEP-ED and REGIONAL OFFICE ACTION: _____________________________________

Classification _____________________ Range ___________________________
Date Approved Processed ____________ Post Audited at Range ______________
(For future Reference)

_________________________ _______________________
Regional Director Evaluator
VI. DEP.ED. PROPER ACTION TITLE: _________________________

_________________________________ Salary: _________________________

Surname, First Name, Middle Name
 Division of Pasig City
City of Pasig
School District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL

CERTIFICATION

TO WHOM IT MAY CONCERN:

I hereby certify under the oath that I’ve been actually in the school listed in
the accompanying Transcript of Records and that I have actually earned the units
indicated therein. As required, the Bureau of State Colleges and Universities has
been furnished with authentic copies of the sworn statement and its enclosures.

_____________________
Teacher 1

SUBSCRIBED AND SWORN TO before me this ______ of in

Pasig City affiant exhibiting His/Her Residence Certificate No.
_______________ issued at Pasig City on ______________.

___________________________________
Signature of Person Administering the Oath
 Republic of the Philippines
Department of Education
National Capital Region
Division of Pasig City
District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL
School

EQUIVALENT RECORD FORM

NAME: ________________________ Date of Birth: ____________ Employee No: _________

Authorized Position Title: Teacher 1 Form No._____________ PSI HP Blg. _________
Authorized Salary: _ _________ Item No.: _____________________________ CY: 2013

I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:

Title, Degree or Name of Institution Year Civil
Highest Grade Received Service Rating Date of
Examination
Attained Eligibility

II. SERVICE RECORDS (Attached Duly Certified Service Record)

III. EQUIVALENT UNITS:
A. Total No. of year in Teaching: (Public Only) _________ Equivalent ______
B. Degree to Degree Equivalent _____ MAED Equivalent ______
C. Areas of Equivalent: School Year: No. of Units: Description:
3. Professional Study ______ ______ MAED. Educ. Management
4. Teaching Experiences
a. Public Schools _________________
b. Private Schools ___ _ __
3. Admin. Supervisory Experience
c. Public School _________NA___________
d. Private Schools _______ NA __________
4. Others: (Seminars, Workshop, etc.) (See attached page)
TOTAL: _________________

________________________
ZENAIDA G. SAN BUENAVENTURA Teacher’s Signature
Principal CELIA C. PAULINO
Coordinating Principal

LATEST EFFICIENCY RATING: VS School: Nagpayong Elementary

NOTE: Teachers DO NOT WRITE BELOW District: I, Pasig I
IV. Division Action Date Range Salary Salary
Processed Assignment Range Schedule REMARKS

RECOMMENDING APPROVAL:

___________________
Asst. Schools Division Superintendent
Officer – In - Charge

V. DEP-ED and REGIONAL OFFICE ACTION: _____________________________________

Classification _____________________ Range ___________________________
Date Approved Processed ____________ Post Audited at Range ______________
(For future Reference)

_________________________ _______________________
Regional Director Evaluator
VI. DEP.ED. PROPER ACTION TITLE: _________________________

_________________________________ Salary: _________________________

Surname, First Name, Middle Name