MANUAL VERIFICATION FORM

Date:

To: CHINABANK SAVINGS - ___________

Address:

Borrower’s Loan Information:

Name of Borrower:

Designated School:

Loan Amount:

Loan Term:

Monthly Amortization:

Effectivity Date:

Termination Date:

In accordance with DepEd’s Terms and Conditions of the APDS Accreditation (TCAA), the undersigned
authorized DepEd Verifier hereby attests that the above mentioned DepEd employee:

1. Has a sufficient Net Take Home Pay of 5,000 after CBS deduction as set by the 2018 GAA;
2. Has no undeducted or on queue obligation as per updated records;
3. Is a legitimate employee of the aforementioned institution;

Furthermore the verifier as attested in this manual verification form complies with the First In/First
Served Billing as stated in the 2018 TCAA hence; assuring that the monthly amortization indicated
herein will be reflected and deducted on the employee’s salary on the abovementioned effectivity date.

Any misrepresentation on the details declared on this form shall render the Outstanding Loan Balance
due and demandable.

Verified By:

________________________
(Signature Over Printed Name and Date)
AUTHORIZED DEPED VERIFIER