Department of Education

Region V
Division of Camarines Sur
DEL GALLEGO DISTRICT

________________
(Date)

The Schools Division Superintentdent

Division of Camarines Sur
Freedom Sports Complex
San Jose, Pili, Camarines Sur
(Thru Channels)

MADAM:

I have the honor to apply for _______Four____(_4__) ______working__ daysSick /

Maternity / Personal / Vacation leave of absence with / without pay fromMarch
15, 2016 to March 18,2016.

I further request that my leave of absence be offset by the following duly earned service
credits to wit;

Attached herewith is / are my

____________Form 6 duly accomplished____________________________________________
______________________________________________________________________________

Very truly yours,

MA. LEAH R. SUARILLA

Position: Teacher-I
Emp. No. 4820472

Recommending Approval:

MARCELA R. COLLANTES
Head Teacher-I
 Department of Education
Region V
Division of Camarines Sur
DEL GALLEGO DISTRICT

September 9,2019
(Date)

The Schools Division Superintentdent

Division of Camarines Sur
Freedom Sports Complex
San Jose, Pili, Camarines Sur
(Thru Channels)

MADAM:

I have the honour to apply for reinstatement to service effective September

12, 2019. I was on sick / maternity / personal / vacation leave of absence from May 30, 2019 to
September 12, 2019.
Attached here with is / are;
Birth Certificate of my child, Appointment, and Medical Certificate.

Very truly yours,

CAMILLE GREY I. RAZONA

Position: Teacher-I
Emp. No. 4820603

Recommending Approval:

FRANCIA C. OLIVEROS
Principal-I
 Department of Education
Region V
Division of Camarines Sur
DEL GALLEGO DISTRICT

August , 2016
The schools Division Superintendent
DepEd Division of Camarines Sur
San Jose, Pili, Camarines Su
(Thru Channel)

SIR:

I have the honor to apply for MATERNITY LEAVE for the period
from , 2016- , 2016 inclusive

My data information are as follows:

1. Station of Assignment: STA. RITA ELEMENTARY SCHOOL

2. Employee No. 4588286
3. First Day of Service during the year: JUNE 13, 2016
4. Absence incurred, if any, prior to this leave: NONE
5. Status: PERMANENT
6. Salary per month (Current) Php. 19, 286.00
7. Affectivity of permanent/ provisional status: JULY 28, 2011
8. Specific Period of Leave: , 2016 - , 2016

Enclosed herewith are the supporting papers in connection with this application for leave
of absence.

Recommending Approval: Very Truly Yours,

JOCELYN B. REVADINERA GINA B. MAIWAT

School Head Teacher-I

Incs: __________ Cs form 6

__________ CS Form 41
__________ S.O. of unused service credits

1st Endorsement
Del Gallego District
Del GallegoCamarines Sur

Respectfully forwarded to the Schools Division Superintendent for

Camarines Sur, San Jose Pili, Camarines Sur, recommending approval of GINA B. MAIWAT
of STA. RITA ELEMENTARY SCHOOL this district for leave of absences as indicated
above effective : , 2016 - , 2016 inclusive.

LIZA S. FROA
Public Schools District Supervisor
Incls: as Stated
 Republic of the Philippines
Department of Education
Region V
Division of Camarines Sur
DEL GALLEGO DISTRICT

August , 2016

STA. RITA ELEMENTARY SCHOOL

Name of School

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify GINA B. MAIWAT______ TEACHER –I

Name of Teacher Designation
of this school and / or district has been cleared of all money and property responsibility in
this school/ district as of today August , 2016. Thus (X)COMPLETE CLEARANCE in
this school/ district is hereby granted. Consequently, turnover of property responsibility has been
made to his/ her successor in the service. ( In case of Head of School, District Supervisor/ Chief
Cluster Principal, an Invoice receipt for Property Turnover is required.) However, the above
mentioned person has completely accounted for all Government Property received by him/ her
during his/ her tenure of service in this school / district.

ANA MARILOU M. SACDALAN HENRY CAREN J. FLORENDO

School Property Custodian School Finance Officer

JOCELYN B. REVADINERA
School Head

a. Latest and Complete Address: SABANG, DEL GALLEGO, CAMARINES SUR

b. Amount paid for Property Losses to School Head/ School/ District Property
Custodian/ Chief Cluster Principal ____________________________
c. Purpose of Clearance MATERNITY LEAVE
( Retirement/ Transfer/ Resignation, etc.)
d. Other Information:
Transfer to what school ______________________________________
Address __________________________________________________
Other matters settled, etc. ____________________________________

GINA B. MAIWAT
Name and Signature of Person Seeking Clearance
 Republic of the Philippines
Department of Education
Region V
Division of Camarines Sur
DEL GALLEGO DISTRICT

August , 2016

STA. RITA ELEMENTARY SCHOOL

Name of School

DEL GALLEGO
Name of District

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify GINA B. MAIWAT______ TEACHER –I

Name of Teacher Designation
of this school and / or district has been cleared of all money and property responsibility in this
school/ district as of today August , 2016. Thus (X)COMPLETE CLEARANCE in this
school/ district is hereby granted. Consequently, turnover of property responsibility has been
made to his/ her successor in the service.. ( In case of Head of School, District Supervisor/ Chief
Cluster Principal, an Invoice receipt for Property Turnover is required.) Moreover, the above
mentioned person has completely accounted for all Government Property received by him/ her
during his/ her tenure of service in this school / district.

ANA MARILOU M. SACDALAN JOCELYN B. REVADINERA

School Property Custodian School Head

SHIELA S. RONQUILLO LIZA S. FROA

District Property Custodian Public Schools District Supervisor

a. Latest and Complete Address: SABANG, DEL GALLEGO, CAMARINES SUR

b. Amount paid for Property Losses to School Head/ School/ District Property
Custodian/ Chief Cluster Principal ____________________________
c. Date of Payment __________________________________________
d. Purpose of Clearance MATERNITY LEAVE
( Retirement/ Transfer/ Resignation, etc.)
e. Other Information:
Transfer to what school ______________________________________
Address __________________________________________________
Other matters settled, etc. ____________________________________
GINA B. MAIWAT
Name and Signature of Person Seeking Clearance