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DepEd-Request-Form-2-1

The document is a request form from Rechel Lantaca Segarino for a salary adjustment due to a promotion effective September 1, 2023. It includes personal information such as employee number, contact details, and school affiliation. The request also specifies required attachments for processing the salary adjustment.

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Rechel Segarino
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19 views

DepEd-Request-Form-2-1

The document is a request form from Rechel Lantaca Segarino for a salary adjustment due to a promotion effective September 1, 2023. It includes personal information such as employee number, contact details, and school affiliation. The request also specifies required attachments for processing the salary adjustment.

Uploaded by

Rechel Segarino
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education (DepEd)


Regional Office VIII
Division of Leyte
Government Center, Candahug, Palo, Leyte

August 13, 2024


Date

REQUEST FORM

REQUEST FOR SALARY ADJUSTMENT & DEDUCTIONS/ STOPPAGE OF INSURANCE


PREMIUMS, LOANS & OTHERS

_________________ _________________ __________________ _________________


Request for Salary Adjustment
_________________ _________________ __________________ _________________

REASON/S:
The undersigned would like to request for salary adjustment due to promotion,
effective last September 1, 2023.

COMPLETE NAME OF EMPLOYEE


W/ FULL MIDDLE NAME: RECHEL LANTACA SEGARINO
EMPLOYEE NUMBER: 6294546
DIVISION NUMBER: 105
STATION NUMBER: 057
GSIS BP NUMBER: 2005146492
TIN: 314-783-523
BIRTHDATE (mm/dd/year): DECEMBER 17, 1992
SEX: FEMALE
CIVIL STATUS: SINGLE
NO. OF DEPENDENTS: 2
CONTACT NUMBER: 09561493043
DBP ATM ACCOUNT NUMBER: 7655226777
HOME ADDRESS: OMAGANHAN, TABANGO, LEYTE
PHILHEALTH NUMBER: 12-051226771-3
PAG-IBIG NUMBER: 9131-9014-3834
SCHOOL/DISTRICT: OMAGANHAN ELEMENTARY SCHOOL- TABANGO
NORTH DISTRICT
STATUS OF APPOINTMENT REGULAR PERMANENT
FROM PREVIOUS TO PRESENT
POSITION:

__________________________
SIGNATURE
Republic of the Philippines
Department of Education (DepEd)
Regional Office VIII
Division of Leyte
Government Center, Candahug, Palo, Leyte

August 13, 2024


Date

REQUEST FORM

REQUEST FOR SALARY ADJUSTMENT & DEDUCTIONS/ STOPPAGE OF INSURANCE


PREMIUMS, LOANS & OTHERS

_________________ _________________ __________________ _________________


Request for Salary Adjustment
_________________ _________________ __________________ _________________

REASON/S:
The undersigned would like to request for salary adjustment due to promotion,
effective last September 1, 2023.

COMPLETE NAME OF EMPLOYEE


W/ FULL MIDDLE NAME: RECHEL LANTACA SEGARINO
EMPLOYEE NUMBER: 6294546
DIVISION NUMBER: 105
STATION NUMBER: 057
GSIS BP NUMBER: 2005146492
TIN: 314-783-523
BIRTHDATE (mm/dd/year): DECEMBER 17, 1992
SEX: FEMALE
CIVIL STATUS: SINGLE
NO. OF DEPENDENTS: 2
CONTACT NUMBER: 09561493043
DBP ATM ACCOUNT NUMBER: 7655226777
HOME ADDRESS: OMAGANHAN, TABANGO, LEYTE
PHILHEALTH NUMBER: 12-051226771-3
PAG-IBIG NUMBER: 9131-9014-3834
SCHOOL/DISTRICT: OMAGANHAN ELEMENTARY SCHOOL- TABANGO
NORTH DISTRICT
STATUS OF APPOINTMENT REGULAR PERMANENT
FROM PREVIOUS TO PRESENT
POSITION:

For Salary Adjustment please attach the following:


 Appointment
 Certificate of Funding
 NOSA
 Payslip

__________________________
SIGNATURE

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