Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
LA UNION SCHOOLS DIVISION OFFICE
EQUIVALENT RECORD FORM
NAME:_________________________________________ DATE OF BIRTH_______________GENDER________
(Last Name) (First Name) (Middle Name)
EMPLOYEE NO.___________________________________ AUTHORIZED POSITION TITLE___________________
(Present)
ITEM NO._______________________________________ AUTHORIZED SALARY:________________________
(Annual salary of present position-STEP I)
I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY
DEGREE OR NAME OF SCHOOL YEAR CIVIL SERVICE DATE OF
HIGHEST INSTITUTION EXAM/PBET/LET EXAM.
DEGREE
ATTAINED
II. SERVICE RECORDS: ATTACHED DULY CERTIFIED SERVICE RECORDS
III. EQUIVALENT UNITS
A. Total No. of Years Teaching (Public Only)______________ Equivalent:_________________
B. Degree to degree Equivalent (Present Degree) ________ Equivalent:_________________
C. AREAS OF EQUIVALENT SCHOOL YEAR NO. OF DESCRIPTION
UNITS
1. Professional Study
2. Teaching Experience
a. Public School
b. Private School
3. Adm. Supervisory
a. Public School
b. Private School
4. Other
(Seminar/Workshop/Training, etc.)
Latest Performance Rating: _____________________
__________________________________ ____________________
Teacher’s Signature School Head
_________________________________________________________________________________________________
NOTE: Teachers do not write below
IV. DIVISION ACTION
Classification Date Grade Salary Scheduled Remarks
Processed Assignment Grade Salary
CERTIFIED CORRECT: RECOMMENDING APPROVAL:
DOMINGA N. LIM ATTY. DONATO D. BALDERAS JR.
Administrative Officer V Schools Division Superintendent
V. DepEd Regional Office Action
Classification:_________________________ _____ Salary Grade______________________________
Date Approved/Processed: __________________ Post audited at Salary Grade: _________________
Reviewed by: *APPROVED
*The approval of the Equivalent Record Form is automatically cancelled if his/her records upon which the approval is
based are later found fictitious or fraudulent