CS Form No.

67 Revised 1987

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

SERVICE RECORD
(To be accomplished by the Employer)

Name : IDOS MICHAEL PERRION

Surname Given Name Middle Name

Birth: March 16, 1977 Alcala, Pangasinan

Date of Birth Place of Birth

This is to certify that the employee named herein above actually rendered services in this office as in 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

Inclusive Date Designation Status(1) Salary (2) Station/Place
Malimpin NHS,
06/05/17 12/31/17 Teacher II Provisional 256,644.00
Dasol
Malimpin NHS,
01/01/18 06/25/18 -do- 265,788.00
" Dasol
Malimpin NHS,
06/26/18 12/31/18 -do- 265,788.00
" Dasol
Malimpin NHS,
01/01/19 12/31/19 -do- 275,256.00
" Dasol
Malimpin NHS,
01/01/20 present -do- 293,940.00
" Dasol
Date: 1/29/2020
Certified True and Corr

RAFAEL IRWIN G. NICOLA

Administrative Officer
NAN

DO NOT PRINT this area

PERRION
Middle Name

**** REMARKS
STEP INCREMENT
MAGNA CARTA
this office as in the service NBC (National Budget Circular)-tranche
e and approved

OFFICE/ENTITY/DIVISION L/V ABS. REMARKS

Branch (3) w/o pay

Nat.(M)

" NBC 572

" Reappointment

" NBC 575

" NBC 579

 Certified True and Correct:

AFAEL IRWIN G. NICOLAS, ED. D

Administrative Officer V
CS Form No. 67 Revised 1987

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

SERVICE RECORD
(To be accomplished by the Employer)

Name : MOVILLA JAYBE MEULIO

Surname Given Name Middle Name

Birth: April 16, 1991 Candelaria, Zambales

Date of Birth Place of Birth

This is to certify that the employee named herein above actually rendered services in this office as in 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

Inclusive Date Designation Status(1) Salary (2) Station/Place
Ilog-Malino NHS,
06/28/19 08/03/19 Substitute Regular 249,048.00
Bolinao
Malimpin NHS,
09/02/19 12/31/19 Teacher II Permanent 275,256.00
Dasol
Malimpin NHS,
01/01/20 present " " 293,940.00
Dasol
Date: 1/29/2020
Certified True and Corr

RAFAEL IRWIN G. NICOLA

Administrative Officer
NAN

DO NOT PRINT this area

MEULIO
Middle Name

**** REMARKS
STEP INCREMENT
MAGNA CARTA
this office as in the service NBC (National Budget Circular)-tranche
e and approved

OFFICE/ENTITY/DIVISION L/V ABS. REMARKS

Branch (3) w/o pay

(Nat'l) M

"

"
NBC 579
 Certified True and Correct:

AFAEL IRWIN G. NICOLAS, ED. D

Administrative Officer V
CS Form No. 67 Revised 1987

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

SERVICE RECORD
(To be accomplished by the Employer)

Name : NOOL DARIA ROSE BASUEL

Surname Given Name Middle Name

Birth: February 28, 1992 Dasol, Pangasinan

Date of Birth Place of Birth

This is to certify that the employee named herein above actually rendered services in this office as in 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

Inclusive Date Designation Status(1) Salary (2) Station/Place
Contractual (Full Malimpin NHS,
08/10/17 12/31/17 Teacher II 256,644.00
Time) Dasol
Malimpin NHS,
01/01/18 02/06/18 -do- 265,788.00
" Dasol
Malimpin NHS,
02/28/18 05/31/18 Teacher I Provisional 242,148.00
Dasol
Malimpin NHS,
06/08/18 12/31/18 -do- 242,148.00
" Dasol
Malimpin NHS,
01/01/19 12/31/19 -do- 249,048.00
" Dasol
Malimpin NHS,
01/01/20 present -do- 267,792.00
" Dasol
Date: 1/29/2020
Certified True and Corr

RAFAEL IRWIN G. NICOLA

Administrative Officer
NAN

DO NOT PRINT this area

BASUEL
Middle Name

**** REMARKS
STEP INCREMENT
MAGNA CARTA
this office as in the service NBC (National Budget Circular)-tranche
e and approved

OFFICE/ENTITY/DIVISION L/V ABS. REMARKS

Branch (3) w/o pay

Nat.(M)

" NBC 572

" Reemployment

" Reappointment

" NBC 575

" NBC 579

 Certified True and Correct:

AFAEL IRWIN G. NICOLAS, ED. D

Administrative Officer V
CS Form No. 67 Revised 1987

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

SERVICE RECORD
(To be accomplished by the Employer)

Name : SORIANO MARIE ESTELLA BALONSO

Surname Given Name Middle Name

Birth: November 29, 1984 Dasol, Pangasinan

Date of Birth Place of Birth

This is to certify that the employee named herein above actually rendered services in this office as in 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

Inclusive Date Designation Status(1) Salary (2) Station/Place
Administrative Malimpin NHS,
11/15/16 12/31/16 Permanent 184,416.00
Assistant II Dasol
Malimpin NHS,
01/01/17 12/31/17 -do- 189,816.00
" Dasol
Malimpin NHS,
01/01/18 12/31/18 -do- 195,384.00
" Dasol
Malimpin NHS,
01/01/19 11/14/19 -do- 201,096.00
" Dasol
Malimpin NHS,
11/15/19 12/31/19 -do- 202,920.00
" Dasol
Malimpin NHS,
01/01/20 present -do- 211,956.00
" Dasol
Date: 1/29/2020
Certified True and Corr

RAFAEL IRWIN G. NICOLA

Administrative Officer
NAN

DO NOT PRINT this area

BALONSO
Middle Name

**** REMARKS
STEP INCREMENT
MAGNA CARTA
this office as in the service NBC (National Budget Circular)-tranche
e and approved

OFFICE/ENTITY/DIVISION L/V ABS. REMARKS

Branch (3) w/o pay

(Nat'l) M

" NBC 568

" NBC 572

" NBC 575

" NOSI SG 8-2

" NBC 579

 Certified True and Correct:

AFAEL IRWIN G. NICOLAS, ED. D

Administrative Officer V
CS Form No. 67 Revised

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

SERVICE RECORD
(To be accomplished by the Employer)
DO NOT PRINT this area
Name : VARGAS JERICHO MARTINEZ
Surname Given Name Middle Name

Birth: March 18, 1994 Lingayen, Pangasinan

Date of Birth Place of Birth **** REMARKS
STEP INCREMENT
MAGNA CARTA
This is to certify that the employee named herein above actually rendered services in this offic NBC (National Budget Circular)-tranch
record below each line of which is supported by appointment and other papers actually issued by this offi
by the authorities concerned.

SERVICE RECORD OF APPOINTMENT OFFICE/ENTITY/DIVISION L/V ABS. REMARKS

Inclusive Date Designation Status(1) Salary (2) Station/Place Branch (3) w/o pay
Malimpin NHS,
08/11/17 12/31/17 Teacher II Permanent 256,644.00
Dasol Nat.(M)
Malimpin NHS,
01/01/18 12/31/18 -do- 265,788.00
" Dasol " NBC 572
Malimpin NHS,
01/01/19 12/31/19 -do- 275,256.00
" Dasol " NBC 575
Malimpin NHS,
01/01/20 present -do- 293,940.00
" Dasol " NBC 579
Date: 1/29/2020
Certified True and Correct:

RAFAEL IRWIN G. NICOLAS, ED. D

Administrative Officer V
cular)-tranche