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Service Record

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cabertomiraclejoy2018
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62 views1 page

Service Record

Uploaded by

cabertomiraclejoy2018
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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SERVICE RECORD

(To Be Accomplished By The Employer)

NAME: (If married woman, give also full


(Family Name) (Given Name) (Middle Initial) maiden name)

(Date herein should be checked from


(Date of Birth) (Place) birth or baptismal certificate or some
other reliable documents.)

This is to certify that the employee named herein above actually rendered services in this Office
as shown by the service record below, each line of which is supported by appointment and other
papers actually issued by this Office and approved by the authorities concerned:

SERVICE RECORD OF APPOINTMENT OFFICE ENTITY/DIVISION L/V ABS SEPARATION

(Inclusive Dates) Designation Status Salary Station / Place Branch W/O Pay (4)

From To (1) (2) of Assignment (3) Date Cause

Issued in compliance with Executive Order No. 54 dated August 10, 1954 and in
accordance with Circular No. 58, dated August 10, 1954 of the System.

CERTIFIED CORRECT:

BENITO G. BACLAGON JR.


Date Administrative Officer V

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