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CS Form No. 1 Appointment Transmittal and Action Form
CS Form No. 1 Appointment Transmittal and Action Form
1
Revised 2017
For Use of Regulated
APPOINTMENT TRANSMITTAL AND ACTION FORM
AGENCY:
AGENCY : CITY SCHOOLS DIVISION OF BATAC CSCFO In-Charge:
PERIOD OF EMPLOYMENT or
DATE OF DATE
Name EMPLOYMENT NATURE OF indicate period MODE
(for Temporary, Casual/ ISSUANCE
Last Name First Name Extension Middle Name STATUS APPOINTMENT of publication (CSC Bulletin of
Contractual Appointments) (mm/dd/yyyy)
(Jr. / III) (mm/dd/yyyy to mm/dd/yyyy) (mm/dd/yyyy to Vacant Positions)
mm/dd/yyyy)
No. (indicate
parenthetical title, if
applicable)
1 Dela Cruz Sheila Dela Cruz Teacher I 9-1 Substitute Reemployment 01/05/2018 NA NA
D=
Disapproved
2 xxx xxx xxx xxx xxx xxx
PAY xxx xxx xxx xxx
3 GRADE
4 P469,812.00
4
5
6
7
8
9
10
11
12
13
14
15
CERTIFICATION
This is to certify that the information contained in this form are true, correct and complete.
JOEL P. MALUNAO
Administrative Officer V
Date: _________________________________
CSC ACTION
Agency
Date of Receiving
Date of Action
Release Officer
(mm/dd/yyyy)
(mm/dd/yyyy)
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CHECKLIST OF COMMON REQUIREMENTS HRMO
Instructions: Put a check if the requirements are complete. If incomplete, use the space provided to indicate the name of appointee and the lacking requirement/s.
APPOINTMENT FORMS (CS Form No. 33-A, Revised 2017) - Three (3) original
1 copies of appointment form (employee copy, CSC copy and agency copy)
____________________________________
Highest Ranking HRMO
CSC FO
me of appointee and the lacking requirement/s.
____________________________________
CSC FO Receiving Officer
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