EQUIVALENT RECORD FORM (ERF) CHECKLIST: 1) Equivalent Record Form —_- 6 copies 2.) Sworn Statement = 2.copies 3,) Service Record = 2.copies 4.) PRC License = 2.copies 5.) Transcript of Records a.) Undergraduate - 2 copies b,) Masteral studies - 2 copies 6.) Performance Rating = 2copies (please NOT BACK to BACK) each SY: 2019 - 2020 IPCRF SY: 2018 - 2019 IPCRF SY: 2017 - 2018 IPCRF 7.) Permit to Study = 2 copies 8.) Copy of appointment = 2 copies * Authentication of ALL PHOTOCPIES should be done by the ADMINISTRATIVE OFFICER ONLY * Please SUBMIT ORIGINAL COPY for verification * Please USE FASTENER not SLIDER in your foldersRepublic of the Philippines Department of Education Region X — Northern Mindanao DIVISION OF CAGAYAN DE ORO Fr. William Masterson Ave., Upper Balulang, Cagayan de Oro City CERTIFICATION TO WHOM IT MAY CONCERN: | hereby certify under oath that | have actually enrolled in the school listed in the accompanying Transcript of Records required by the Department of Education and has been furnished with authenticated copies sworn statement and enclosure and that | have actually earned the units indicated therein Name of Teacher SUBSCRIBED and SWORN to before me this day of affiant exhibit his/her Residence Certificate No. issued on at Cagayan de Oro City.Republic of the Philippines Department of Education Region X DIVISION OF CAGAYAN DE ORO Fr. william Masterson Ave., Upper Balulang, Cagayan de Oro City EQUIVALENT RECORD FORM Name : Date of Birth: Sex: (Surname) (Given Name) (MA) Employee No. ‘Authorized Position Title: Item No. ‘Authorized Salary: |. EDUCATIONAL ATTAINMENT and CIVIL SERVICE ELIGIBILITY Title, Degree or Year CIVIL SERVICE ELIGIBILITY Highest Degree Name of Institution Recelved Exam | Rating | Date Attained Taken T SERVICE RECORD (attached duly certified and upadated Service Record) 1M, EQUIVALENT UNITS: {A Total no. of years teaching: (public only) Equivalent B. Degree of degree equivalent: (present dagree), Equivalent: . Areas of Equivalents: ‘School Year Units Earned 1.) Professional Study 2.) Teaching Experiences 1. Public Schoo! b. Private School 3) Admin. Supervisory Exp. ‘a Public Schoo! b. Private School 4,) Others (seminars, work, etc.) LATEST EFFICIENCY RATING: PSDS/PRINCIPAL/HEAD TEACHER Teacher's Signature NOTE: For Division Processing Officer W. Division Date Range Salary Schedule ‘Action Process ‘Assignment Range Salary Remarks Classification CERTIFIED CORRECT: RECOMMENDING APPROVAL: CYNTHIA V. YAREZ OWENA CHERRY MAE L. LIMBACO Public Schools District Supervisor (1C-Administrative Services [Assistant Schools Divison Superintendent \V. DepED REGIONAL OFFICE ACTION: Evaluated by: Date: Teacher Credential Evaluator Schools Divison Superintendent DEPARTMENT OF EDUCATION REGION X, CAGAYAN DE ORO CITY POST-AUDIT OF TEACHING POSITION CLASS TITLE: SALARY GRADE: SUQJECT TO AVAILABITY OF AN ITEM