Republic of the Philippines

Departnent of Education
Region XII (SOCCSKSARGEN)
DIVISION OF SULTAN KUDARAT
Kenram, lsulan, Sultan Kudarat
Offi cial Webs ite : www. d epedsk n et

REQUEST FOR PAYMENT of SALARY (NEWIY HIREDI

The schools Division Superintendent

DepEd Division of Sultan Kudarat
Kenram, lsulan, Sultan Kudarat

Sir:

We are requesting for the payment of the salary of Mr./Ms.

Teacher of School, .District, for his/her
services -rendered covering the period . Please credit her net
salary to his/her Bank Account Name:
Number:(seeattachedLol),andremithis/hercontributionson
premiums and taxes as follows:
GSIS: BP Numben
HMDF:RTN {see attached apPlication form)
PHlI-HEALTH: PIN # (see attached MDR form)
B-DAY: {attached birth certificate)
TAX : TIN # attached BIR form 1902/2305)
-(see
Attached also are his/her supporting documents (3 copies each) for your perusal:
_1. Approved Appointment 4. Oath of Office (PanunumPa)
2. DTR .5. Community Tax Certificate
3, Certificate of Assumption to Duty .6. SALN (original)
ADDITIONAL REqUIREMENTS (for transferees only)
1. Clearance from Money, Property and Legal Accountabilities
_2. Certificdte of Last Salary received from former agency
_3. Certificate of Available Leave Credits
4. Service Record

Very truly yours,

SCHOOL HEAD

To be filled up by Accounting Section:

NAME BASIC PERA TOTAL GSIS PHIC HMDF TAX NET PAY

Certified Funds Availabler Approved for Payment:

NOLI M. ASUNCION. CPA RAPHAET C. FONTANILLA. Ph.D. CESO V

Accountant lll Schools Division Superintendent