Department of Education

Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

_________________
Date

DIVISION SPECIAL ORDER

NO. ________, s. 20______

RETURN TO DUTY

The return to duty of Mr./Mrs./Miss MARIA JAY B. LLOSALA effective NOVEMBER 10,

2020 from MATERNITY leave of absence from JULY 29, 2020 to NOVEMBER 10, 2020 is hereby

made a matter of record.

Other pertinent data about this teacher is as follows:

1. Place of assignment _______________________________________

2. Station No. ______________________________________________
3. Employee No. ____________________________________________
4. Salary ___________________________________________________
5. Civil Service Status _________________________________________

For the Department of Education

NENE R. MERIOLES, CESO V

Schools Division Superintendent
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
San Pascual South District

Application for Return to Duty from Leave of Absence

The Division Superintendent of Schools ________________

__________________
(Through Channel)

Sir/Madam:

I have the honor to apply for return to duty effective NOVEMBER 10, 2020. I was
granted MATERITY LEAVE for 105 days from JULY 29, 2020 to NOVEMBER 10, 2020.
Enclosed is C.S. Form 211(Medical Certificate)

Very truly yours,

MARIA JAY B. LLOSALA

Teacher
TUBURAN ES
School
4724927
Employee no.
REGULAR/PERMANENT
Status
___________________
Monthly salary
Include
CONTENTS NOTED RECOMMENDING APPROVAL:
____________________ SILVINO B. DOCTOLERO JR.
_________________ District Supervisor
LEAVE GRANTED
Nature of Leave No. of Days Inclusive Period
MINERVA P. REVERAL MATERNITY FROM TO
Principal/School Head LEAVE 105 JULY 29, 2020 NOVEMBER
10, 2020
Date received in the RETURN TO DUTY APPROVED
office Effective _____________
Division Office

NENE R. MERIOLES, CESO V

_____________ Schools Division Superintendent

___________________