CIVIL

SERVICE COMMISSION
Request for Clearance

* All fields are required *Date: 05/16/2019
(mm/dd/yyyy)

Requestor's Name*

RUDAS LADY ALFIE C

Lastname Firstname M.I.

Home Address*

B. ADOLFO ST. BRGY. VICTORY, ABUYOG, LEYTE

Contact No.* Email Address*

0917-771-6271 ladyalfie@yahoo.com

Present Position*

N/A

Name of Agency*
N/A

Address of Agency*

N/A

I respectfully request your good office to issue a clearance in my favour which shall be used for the
purpose/s indicated below: (pls. put an "X")

Promotion

Retirement

Others (pls. specify) X For employment