Republic of the Philippines
DEPARTMENT OF EDUCATION
Region III
SCHOOLS DIVISION OFFICE
CABANATUAN CITY
Maharlika Highway, Cabanatuan City
Website: http://www.depedcabanatuancity.com Email: [email protected]
Tel. Nos.: 044-463-1627 Telefax: No.: 044-4637334
ERF TRANSACTION SLIP
Date: June 24, 2022
Time: 1:19 pm
Name of Applicant : RUSELLE N. DIŇO Contact Number:
Present Position : Teacher I 09276208719
Position Applying for ERF : Teacher 3
Station / School : Juan L. Bautista Elementary School
Masters Degree Course : Master of Arts in Educational Management
Name of Graduate School : Dr. Gloria Lacson college, Foundation
Number of Units earned : MA Graduate
Received/ Processed/ Required Documents (Blue folder) Remarks/
Checked Evaluated Evaluation
EQUIVALENT RECORD FORM 4 original copies
OMNIBUS CERTIFICATION OF AUTHENTICITY 1 original
AND VERIFICATION OF DOCUMENTS (Notarized)
NOTARIZED SELF CERTIFICATION 1 original
TRANSCRIPT OF RECORD (Photocopy must be 1 original,
authenticated by the Registrar) 2 certified true
copies
MA CURRICULUM(Photocopy must be authenticated by 1 original, 2
the Registrar) photocopies
ATTESTED APPOINTMENT 1 photocopy
LATEST PERFORMANCE RATING 1 photocopy
Updated Service Record 2 original
Certification, Authentication and 1 original
Verification (CAV) for Private Graduate Schools 2 photocopies
Received / Checked: Processed / Evaluated:
EVELYN C. SAMONTE
Administrative Officer IV ROSAFE CHARMAINE C. DEL MAR Note : ____________________________________________
Records Unit Schools Division Evaluator
Gentle reminders:
Encode the necessary details in the ERF Template on the next page
For Certification, Authentication and Verification (CAV) please ask assistance from your Graduate School’s Registrars
Office
For training, kindly list three (3) trainings attended only if you have attended more than.
Print Equivalent Record Form in Long bond paper (4 copies) and kindly limit to 1 page only leaving sufficient space
for Division Office and Regional Office Evaluators.
Updated Service Record will be provided by the Division Office
Please submit in Blue Folder
EQUIVALENT RECORD FORM
Name: DIŇO RUSELLE N. Date of Birth: 02/10/1982 Gender: Female
(Surname) (Given) (M.I.)
Employee No. : 4158924 Authorized Position Title: ___________
Item No. : __________________________________ Authorized Annual Salary: ___________
I. Educational Attainment
Master’s Degree Completed/Units Earned Name of School Year Equivalent
(If not completed) Completed
Master of Arts in Educational Management Completed Dr. Gloria Lacson College, 2022
Foundation
II. Years of Teaching Experience: 10 years
Private: _______
Public: √
III. Trainings Attended
TITLE INCLUSIVE DATES NO. OF CONDUCTED/SPONSORED BY
HOURS
IV. For Head Teacher Positions and Other Related Teaching Positions
Years of Experience in Present Position: _______________________
V. Latest Performance Rating: _______ ( O )
____________________________
Teacher Applicant’s Signature
VI. Schools Division Action
Classification Date Processed Range Salary Salary Remarks
Assignment Grade Scheduled
Certified Correct: Recommending Approval:
ROSAFE CHARMAINE C. DEL MAR TERESA D. MABABA, CESO V
Schools Division Evaluator Schools Division Superintendent
VII. DepEd Regional Office Action
Classification :_______________________ Post Audited Assignment:___________________
Date Processed :_______________________ Salary Grade : ___________________
Salary Schedule : ___________________
Remarks : ___________________
Approved:
_______________________________ ________________________________
Teacher Credentials Evaluator II ________________________________
