Republic of the Philippines
Department of Education
Division of Bukidnon
Name of School/District: ______________________________
Address: ________________________
________________
Date
The Regional Director
Department of Education
Regional Office 10 – Northern Mindanao
Cagayan de Oro City
Attention: Payroll Services Unit
Sir:
Please adjust/deduct/stop the deduction(s) being reflected in my salary effective
____________as indicated below.
( ) ADJUST FROM:________________________________________________
TO :________________________________________________
( ) DEDUCT: _________________________________________________
(Name of deduction and deduction code)
From: ________________________ To:__________________
_________________________________________________
(Amount of deduction)
( ) STOP _________________________________________________
(Name of deduction and deduction code)
Reason: ________________________________________________
_________________________________________________
(Amount of deduction)
Very truly yours,
______________________________
Signature over Printed Name of Teacher
Employee Number________________
Recommending Approval/Action
______________________________________________
Schools Division Superintendent/Authorized Representative
In case of Stoppage/Adjustment approval from the private lending/insurance institutions is necessary:
Approved by:
______________________________________________
Name and Designation of Approving Officer
Remarks
_______________________________________________
