Republic of the Philippines                                         Republic of the Philippines
Department of Education                                              Department of Education
                       Region IV-B MIMAROPA                                                Region IV-B MIMAROPA
           DIVISION OF ORIENTAL MINDORO                                         DIVISION OF ORIENTAL MINDORO
                       Sta. Isabel, Calapan City                                            Sta. Isabel, Calapan City
                                               _________________                                            _________________
                                                         Date                                                          Date
NAME: _________________________________________                      NAME: _________________________________________
Designation: _____________________________________                   Designation: _____________________________________
Time Out: ______________(to be filled by the Guard-on-duty)          Time Out :________________(to be filled by the Guard-on-duty)
Time Returned:__ ______________(to be filled by the Guard-on-duty)   Time Returned:__ ____________( to be filled by the Guard-on-duty)
Personal/Official__________________________________                  Personal/Official__________________________________
DESTINATION: ___________________________________                     DESTINATION: ___________________________________
PURPOSE : ______________________________________                     PURPOSE : ______________________________________
NOTE: Time out and time returned to be written by the                NOTE: Time out and time returned to be written by the
       Security Guard/Office Head on duty.                                  Security Guard/Office Head on duty.
               _________________________                                            _________________________
                  Name & Signature of Employee                                         Name & Signature of Employee
IMMEDIATE SUPERVISOR:________________________(Name & Signature)      IMMEDIATE SUPERVISOR:________________________(Name & Signature)
KRYSTEL CHARISMA L. JUMANOY______________________(Signature)         KRYSTEL CHARISMA L. JUMANOY______________________(Signature)
(AO IV/HRMO)                                                         (AO IV/HRMO)
              CERTIFICATE OF APPEARANCE                                            CERTIFICATE OF APPEARANCE
This is to certify that the above named employee/s                   This is to certify that the above named employee/s
appeared before our office on the date and time and for              appeared before our office on the date and time and for
the purpose specified in this locator slip.                          the purpose specified in this locator slip.
   Printed Name           Position            Office   Signature        Printed Name           Position            Office   Signature
                      Republic of the Philippines                                         Republic of the Philippines
                 Department of Education                                                Department of Education
           DIVISION OF ORIENTAL MINDORO                                                    Region IV-B MIMAROPA
                       Sta. Isabel, Calapan City                                DIVISION OF ORIENTAL MINDORO
                                        _________________                                   Sta. Isabel, Calapan City
                                                   Date                                                      _________________
NAME: _________________________________________                                                                        Date
Designation: _____________________________________                   NAME: _________________________________________
Time Out : _______________(to be filled by the Guard-on-duty)        Designation: _____________________________________
Time Returned:__ ____________(to be filled by the Guard-on-duty)     Time Out :_ _______________(to be filled by the Guard-on-duty)
Personal/Official__________________________________                  Time Returned:____________(to be filled by the Guard-on-duty)
DESTINATION: ___________________________________                     Personal/Official__________________________________
PURPOSE : ______________________________________                     DESTINATION: ___________________________________
                                                                     PURPOSE : ______________________________________
NOTE: Time out and time returned to be written by the
       Security Guard/Office Head on duty.                           NOTE: Time out and time returned to be written by the
                                                                            Security Guard/Office Head on duty.
               _________________________
                  Name & Signature of Employee                                      _________________________
                                                                                       Name & Signature of Employee
IMMEDIATE SUPERVISOR:________________________(Name & Signature)
                                                                     IMMEDIATE SUPERVISOR:________________________(Name & Signature)
KRYSTEL CHARISMA L. JUMANOY:______________________(Signature)
(AO IV/HRMO)                                                         KRYSTEL CHARISMA L. JUMANOY:______________________(Signature)
                                                                     (AO IV/HRMO)
              CERTIFICATE OF APPEARANCE
                                                                                   CERTIFICATE OF APPEARANCE
This is to certify that the above named employee/s
                                                                     This is to certify that the above named employee/s
appeared before our office on the date and time and for
                                                                     appeared before our office on the date and time and for
the purpose specified in this locator slip.
                                                                     the purpose specified in this locator slip.
   Printed Name           Position            Office   Signature
                                                                        Printed Name          Position             Office   Signature